Inter-rater agreement of CDC criteria and ASEPSIS score in assessing surgical site infections after cesarean section: a prospective observational study

Author:

Delli Carpini Giovanni,Giannella Luca,Di Giuseppe Jacopo,Fioretti Marco,Franconi Ilaria,Gatti Ludovica,Sabbatini Keti,Montanari Michele,Marconi Chiara,Tafuri Elisa,Tibaldi Luisa,Fichera Mariasole,Pizzagalli Davide,Ciavattini Andrea

Abstract

ObjectiveTo assess and compare the inter-rater agreement of the CDC criteria and the ASEPSIS score in identifying surgical site infections after cesarean section.MethodsProspective observational study including 110 patients subjected to a cesarean section at our institution. Surgical wounds were managed according to standard care and were photographed on the third, seventh, and thirtieth postoperative day or during any evaluation in case of complications. Three expert surgeons reviewed the prospectively gathered data and photographs and classified each wound using CDC criteria and the ASEPSIS score. The inter-rater agreements of CDC criteria and ASEPSIS score were determined with Krippendorff's Alpha with linear weights and compared with a confidence interval approach.ResultsThe weighted α coefficient for CDC criteria was 0.587 (95%CI, 0.411–0.763, p < 0.001, “moderate” agreement according to Altman's interpretation of weighted agreement coefficient), while the weighted α coefficient for the ASEPSIS score was 0.856 (95%CI, 0.733–0.980, p < 0.001, “very good” agreement).ConclusionASEPSIS score presents a “very good” inter-rater agreement for surgical site infections identification after cesarean, resulting in a more objective method than CDC criteria (“moderate” inter-rater agreement). ASEPSIS score could represent an objective tool for managing and monitoring surgical site infections after cesarean section, also by photographic evaluation.

Publisher

Frontiers Media SA

Subject

Surgery

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