Surgical Site Infections (SSIs) for Operative Procedures in California Hospitals

These datasets show surgical site infections (SSIs) reported by California hospitals to the California Department of Public Health (CDPH), Healthcare-Associated Infections (HAI) Program, via the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN), in accordance with Health and Safety Code (HSC) section 1288.55. 

California hospitals track and report deep incisional and organ/space SSIs for adults and pediatric patients for 28 types of operative procedures: 

abdominal aortic aneurysm repair; abdominal hysterectomy; appendix surgery; bile duct, liver or pancreatic surgery, cardiac surgery; Cesarean section; colon surgery; coronary artery bypass graft with both chest and donor site incisions; coronary artery bypass graft with chest incision only*; exploratory abdominal surgery (laparotomy); gallbladder surgery; gastric surgery; heart transplant; hip prosthesis; kidney surgery; kidney transplant; knee prosthesis; laminectomy; liver transplant; open reduction of fracture; ovarian surgery; pacemaker surgery; rectal surgery; small bowel surgery; spinal fusion; spleen surgery; thoracic surgery; vaginal hysterectomy 

The SSI data tables include information on the statewide and hospital-specific SSI incidence by operative procedure types, displaying procedure counts, number of infections observed (reported) and predicted, the standardized infection ratio (SIR) and associated 95% confidence intervals, as well as statistical interpretation to show whether SSI incidence was the same (no different), better (lower), or worse (higher) than the national baseline. Another performance measure in this dataset allows for tracking hospital progress in meeting established HAI reduction goals. Hospitals must have an SIR at or below incremental targets each year to be considered on track. California hospitals should achieve 30% reductions in SSI incidence from 2015 to 2020.

NHSN calculates the predicted number of infections using procedure-specific risk adjustment logistic regression models based on 2015 national baseline data and that accounts for particular patient-level factors and hospital characteristics found to be significant predictors of SSI incidence. The number of predicted infections generated from these models is used to calculate the SIR, a measure of HAI incidence, by dividing the number of actual observed infections by the number of predicted infections.

Beginning in 2024, to comply with the California Information Practices Act (Civ. Code § 1798) and the CDPH Data De-Identification Guidelines (DDG) version 2.0, facilities that performed fewer than 11 pediatric procedures for a specific procedure type or fewer than 11 cesarean sections have had the exact number of procedures, infections, and predicted infections removed. To prevent inferences about the number of low-volume procedures performed in each facility, these procedures are not included in the facility "All procedures" count. STATE OF CALIFORNIA POOLED DATA procedure counts are not given if there are fewer than 11 procedures statewide, and the STATE OF CALIFORNIA POOLED DATA may not include procedures in facilities that performed fewer than 11 procedures (labeled "Does not include procedures at hospitals with fewer than 11 procedures").

Detailed information about the variables included in each dataset are described in the accompanying data dictionaries for the year of interest. For more information about the SIR and NHSN’s statistical models, please review the “NHSN Guide to the SIR” at https://www.cdc.gov/nhsn/ps-analysis-resources/index.html

To link the CDPH facility IDs with those from other Departments, like OSHPD, please refer to the "Licensed Facility Cross-Walk" Open Data table at https://data.chhs.ca.gov/dataset/licensed-facility-crosswalk

For more information about HAIs in California hospitals, please visit: https://www.cdph.ca.gov/Programs/CHCQ/HAI/Pages/AnnualHAIReports.aspx

Tags: abdominal, aortic-aneurysm, appendicitis, arthroplasty, artificial, bile-ducts-and-extrahepatic, bone, california-department-of-public-health, cardiac-surgery, cesarean, cholecystectomy, colectomy, colorectal-surgery, community-hospitals, coronary-artery-bypass, coronary-bypass-graft, digestive-system-surgical-procedures, fractures, gallbladder, gastrectomy, hai, healthcare, heart-transplant, hip-prothesis, hip-replacement, hospitals, hysterectomy, hysterectomy-abdominal, hysterectomy-vaginal, hysteroscopy, internal-mammary-coronary-artery-anastomosis, kidney, kidney-transplantation, knee-prothesis, laminectomy, laparotomy, liver-transplantation, nosocomial-infections, open-reduction-of-fracture, operative-procedures, ovarian, ovarian-surgery, ovary, pacemaker, pancreatic, rectal-neoplasms, rectal-surgery, small-bowel-surgery, spinal-fusion, spine, splenectomy, ssi, surgical, surgical-procedure, surgical-site-infections, surveillance, thoracic-surgery
Organization: State of California