Scoring system for predicting surgical-site infection in neonates and pediatric intensive care units – a preliminary study

Abstract

<b>Introduction:</b> Surgical-site infections (SSI) account for a large proportion of morbidity, with an incidence of 500,000 cases per year from 27 million surgeries. Some researchers have found that the factors contributing to surgical wound infections include the number of bacterial contaminants, the virulence of the bacteria, the micro-environment around the surgical wound, and the immune system of the host.</br></br> <b>Aim:</b> The aim of the study is to calculate the risk factors for surgical-site infections in a neonatal and pediatric intensive care unit and to apply them in a risk index for neonates and pediatrics in critical care units.</br></br> <b>Method:</b> A retrospective cohort study was conducted at Tarakan General Hospital from January 2018 to July 2019 to investigate risk factors for SSIs. The various factors were then analyzed with the chi-square test, whereas the multivariate binary logistic regression model was used to examine independent risk factors for SSIs.</br></br> <b>Results:</b> A total of 179 patients met the inclusion criteria. There were 66 patients in the NICU and 113 in the PICU. The bivariate analysis showed that SSI was associated with the type of ward, the operating room temperature, perioperative septicemia, the length of stay, and the use of chlorhexidine bathing (p < 0.05). The multivariate analysis identified three independent parameters correlating with the occurance of SSI: operating room temperature (odds ratio [OR] 12,510; 95% confidence interval [CI] 4,198 –37,279; p < 0.001); perioperative septicemia (OR 6,424; 95% CI 2,221–18,581; p=0.001); and chlorhexidine bathing (OR 35,751; 95% CI 8,627–148,164; p < 0.001).</br></br> <b>Conclusion:</b> From these three independent paramaters, we recommend a prognostic scoring index for SSIs in postoperative NICU and PICU patients that requires further diagnostic, validity and realibility testing to improve patient outcomes.