Surgical site infections (SSIs) are the most common healthcare-associated infection (HAI) in the United States and account for almost a quarter of all HAIs. Approximately 20% of SSIs in the United States occur following colon surgery.
Surveillance and feedback of SSI rates is a critical component of SSI prevention activities. In 2015, the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN) introduced a required element for SSI surveillance, “present at time of surgery” (PATOS). When SSIs occur following index surgical procedures in which infection at the same depth was visualized and documented in the operative note, these SSIs are deemed PATOS. Beginning in 2017, PATOS SSIs were excluded from the Centers for Medicare and Medicaid Services (CMS) colon (COLO) SSI standardized infection ratio (SIR), a measure used as part of public reporting and federal hospital reimbursement programs.
Since the introduction of this definition, data characterizing PATOS colon SSIs and the impact of excluding PATOS colon SSIs from CMS reporting have been limited. The objectives of this study were to describe the epidemiology of colon SSIs, to compare characteristics between PATOS colon SSIs and non-PATOS colon SSIs, and to describe the impact of excluding PATOS colon surgery SSIs from CMS reporting.