AND RELEVANCE In a broad review of published literature , risk factors for SSI were characterized as describing reduced fitness , patient frailty , surgery duration , and complexity .
IMPORTANCE Surgical site infection ( SSI ) complicates 2 - 5 % of surgeries in the United States .
Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis , and SSIs are responsible for increased morbidity , mortality , and economic burden associated with surgery .
Staphylococcus aureus ( S. aureus ) is a commonly-isolated organism for SSI , and methicillin-resistant S. aureus SSI incidence is increasing globally .
OBJECTIVE The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting .
Risk factors for surgical site infections in older people.
OBJECTIVES To identify risk factors for  surgical site infection ( SSI ) in older people and to test a priori hypotheses regarding particular variables and SSI risk . DESIGN Case-control study . SETTING Duke University Medical Center and seven community hospitals in North Carolina and Virginia . PARTICIPANTS Elderly patients ( > or = 65 ) who underwent surgery between 1991 and 2002 at the study hospitals . Cases were elderly patients with SSI ; controls were elderly operative patients without SSI . Infection control practitioners prospect ively identified patients . MEASUREMENTS Data were collected retrospectively . Case patients who developed SSI were compared with control patients who did not develop SSI . RESULTS Five hundred sixty-nine SSI cases were identified , and 589 uninfected controls were selected . In multivariate analysis , independent predictors of SSI included obesity ( odds ratio (OR)=1.77 , 95 % confidence interval (CI)=1.34 - 2.32 ) , chronic obstructive pulmonary disease ( COPD ) ( OR=1.66 , 95 % CI=1.17 - 2.34 ) , and a wound class classified as contaminated or dirty ( OR=1.65 , 95 % CI=1.01 - 2.72 ) . Having private insurance was associated with lower risk ( OR=0.29 , 95 % CI=0.12 - 0.68 ) . CONCLUSION This study identified several independent predictors of  SSI in older people , including comorbid conditions ( COPD and obesity ) , perioperative variables ( wound class ) , and socioeconomic factors ( private insurance , which was associated with lower risk ) . The results from this study can be used to design and implement interventions for SSI prevention in high-risk older people
AND RELEVANCE In a broad review of published literature , risk factors for SSI were characterized as describing reduced fitness , patient frailty , surgery duration , and complexity .
IMPORTANCE Surgical site infection ( SSI ) complicates 2 - 5 % of surgeries in the United States .
Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis , and SSIs are responsible for increased morbidity , mortality , and economic burden associated with surgery .
Staphylococcus aureus ( S. aureus ) is a commonly-isolated organism for SSI , and methicillin-resistant S. aureus SSI incidence is increasing globally .
OBJECTIVE The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting .