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 .
When to randomize, or 'Evidence-based medicine needs medicine-based evidence'.
The question of “ when to  r and omize  ? ” is arguably too complicated to answer , if it can even be answered definitively , in the text of a several-thous and -word article . From a broad perspective , r and omized studies are relevant to activities and decision making in scientific as well as policy setting s , while also encompassing a wide range of intersecting and overlapping topics . Representative situations include how an individual investigator decides that a r and omized trial is warranted to study a particular research question ; when the Patient-Centered Outcomes Research Institute should commission r and omized or non-r and omized research ; and whether the Food and Drug Administration always needs evidence from r and omized trials to approve new drugs . After a brief discussion of scientific terms , evidence based medicine ( EBM ) , and costs and ethical considerations , the remainder of this article will present an overarching framework to help clarify what r and omization accomplishes and what it does not — from a method ological perspective . Specifically , an argument is presented , with representative examples , focusing on comparative effectiveness research ( CER ) and promoting what can be called medicine-based evidence ( MBE ) . This report is conceptual rather than technical , commenting on general issues rather than details , although work on such details is important and available ( e.g. , see other publications from symposia1 sponsored by the Agency for Healthcare Research and Quality ) . Also of note , comments regarding particular articles are not intended to be ad hominem toward the authors , but they are rather part of a scientific discussion to advance underst and ing
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 .