External Validation of SENIC and NNIS Scores for Predicting Wound Infection in Colorectal Surgery


Objective: We aimed to identify the ratio of Surgical Site Infection (SSI) and also the validity of the National Nosocomial Infection Survellance (NNIS) and Study on the Efficacy of Nosocomial Infection Control (SENIC) risk indexes in colorectal surgery, among Turkish population. Background: Some problems have been reported with the power of NNIS risk index to predict the risk of surgical site infection. We aimed to validate theNNIS and SENIC risk indexes in colorectal surgery. Methods: Between January 2003 and December 2006, surgical site ?nfection survellance was performed to 107 patient who undergo colorectal surgery with NNIS and SENIC risk scales. The mean patient age was 48 years (range, 17 to 86), and 61.7% of the group (66) was female. For this patient cohort, 6 (5.6%) were diagnosed with incisional SSI. While the mean Body Mass Index (BMI) of all patients was 26.6; mean value of BMI among the patiens with SSI was 27.8.Results: 6 insicional surgical site infection were observed during the study. According to Receiver Operating Characteric (ROC) curve analyze neither NNIS with avalue of 0.70, nor SENIC with a value of 0.67 are perfect risk indexes. Conclusion: As a result both NNIS and SENIC ?s a good risk indexes but not perfect. Scarcely when NNIS and SENIC is used together to predict the SSI they forecast the development of infection better. But there is a lot of other factors that effect the development of SSI, so for excellent surveillance risk index those factors known by everyone must be added to risk index scales.

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T. Akin, M. Akin, S. Topaloğlu, H. Berkem, B. Yüksel, S. Hengirmen, Y. Yildiz and M. Tez, "External Validation of SENIC and NNIS Scores for Predicting Wound Infection in Colorectal Surgery," Surgical Science, Vol. 2 No. 2, 2011, pp. 73-76. doi: 10.4236/ss.2011.22016.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] A. C. A. Clements, E. N. C. Tong, A. P. Morton and M. Whitby, “Risk Stratification for Surgical Site Infections in Australia: Evaluation of the US National Nosocomial Infection Surveillance Risk Index,” Journal of Hospital Infection, Vol. 66, No. 2, 2007, pp. 148-155. doi:10.1016/j.jhin.2007.02.019
[2] J. I. Barrasa Villar, I. Domingo Cuevas, F. Vizmanos Sevilla, “Use of the NNIS Index for Determining the Intrinsic Risk of Surgical Infection,” Medicina clínica Facultad de Medicina de Barcelona , Vol. 107, No. 20, 1996, pp. 767-771.
[3] Christian Brandt, Sonja Hanmsen, Dorit Sohr, Franz Dascher and Henning Rüden; “Finding a Method for Optimizing Risk Adjustment when Comparing Surgical-Site Infection Rates,” Infection Control and Hospital Epidemiology, Vol. 25, No. 4, 2004, pp. 313-318. doi:10.1086/502398
[4] D. H. Culver, T. C. Horan and R. P. Gaynes, “Surgical Wound Infection Rates by Wound Class, Operative Procedure, and Patient Risk Index: Nasional Nosocomial Infections Surveillance System,” American Journal of Medicine, Vol. 91, 1991; pp. 152-157. doi:10.1016/0002-9343(91)90361-Z
[5] J. Devrick, Anderson, F. Luke Chen, J. Daniel Sexton, “Complex Surgical Site Infections and the Devilish Details of Risk Adjustment: Important Implications for Pub- lic Reporting,” Infection Control and Hospital Epidemiology, Vol. 29, No. 10, 2008, pp. 941-946.
[6] L. P. E. Eveline Geubbles, PhD; E. Diederick Grobbee, MD PhD; “Improved Risk Adjustment for Comparison of Surgical Site Infection Rates,” Infection Control and Hospital Epidemiology, Vol. 27, No. 12, 2006, pp. 1330-1339.
[7] Gaynes RP, Culver DH, Horan TC, Edwards JR, Ricards C, Tolson JS. “Surgical Site Infection (SSI) Rates in the United States, 1992-1998: the National Nosocomial Infections Surveillance System Basic SSI Risk Index,” Clinical Infectious Diseases, Vol. 33, 2001, pp. 69-77. doi:10.1086/321860
[8] R. W. Haley, D. H. Culver, W. M. Morgan, J. W. White, T. G. Emori, T. M. Hootan,. “Identifying Patient at High Risk of Surgical Wound Infection: a Simple Multivariate Index of Patient Susceptibility and Wound Contamination,” American Journal of Epidemiology, Vol. 121, No. 2, 1985, pp. 6-15.
[9] A. M. Korinek. “Risk Factors for Neurosurgical Site Infections after Craniotomy: a Prospective Multicenter Study of 2944 Patients: the French Study Group of Neurosurgical Infections, the SEHP and the C-CL?N Paris-Nord, Service Epidemiologie Hygiene et Prevention,” Neurosrgery, Vol. 41, No. 5, 1997, pp. 1073-1079. doi:10.1097/00006123-199711000-00010
[10] Maria lea campos, MD, MSC, R. N. Zulmira Miotello Cipriaono,; Paulo Fontoura, MD, PhD. “Suitab?l?ty of the NNIS Index for Estimating Surgical-Site Infection Risk at a Small University Hospital in Brazil,” Infection Control and Hospital Epidemiology, Vol. 22, 2001, pp. 268-272. doi:10.1086/501898
[11] N. Deborah Friedman, MBBS, FRACP; L. Ann Bull, PhD; L. Philip Russo, MClinEpid; Lyle Gurrin, PhD;Michael Richards, MBBS, FRACP, MD. “Perform- ance of the National Nosocomial Infections Suveillance Risk Index in Predicting Surgical Site Infection in Australia,” Infection Control and Hospital Epidemiology, Vol. 28, No. 1, 2007, pp. 55-59. doi:10.1086/509848
[12] L. Robert Smith, MD, K. Jamie Bohl, MD, T. Shannon McElearney, MD, M. Charles Friel, MD, M. Margaret, R. N. Barclay, G. Robert. et al. “Wound Infection After Elective Colorectal Resection,” Annals of Surgery, Vol. 239, No. 5, 2004.
[13] R. Tang, H. H. Chen, Y. L. Wang, et al. “Risk Factors for Surgical Site Infection after Elective Resection of the Colon and Rectum: A Single-Center Prospective Study of 2809 Consecutive Patients,” Annals of Surgery, Vol. 234, No. 2, 2001, pp. 181-189. doi:10.1097/00000658-200108000-00007
[14] S. Topaloglu, M. Ak?n, H. Ozel, E. Polat, T. Ak?n, et al. “Correlation of Risk and Postoperative Assessment Methods in Wound Surveillance,” Journal of Surgical Research, Vol. 146, No. 2, 2008, pp. 211-217. doi:10.1016/j.jss.2007.05.016
[15] Yoke-Fong Ch?ew and Jean-Claude The?s. “Compar?son Of Infect?on Rate Us?ng D?fferent Methods Of Assessment For Surve?llance Of Total Hip Replacement Surgical Site Infections,” Australian and New Zealand Journal of Surgery, Vol. 77, 2007, pp. 535-539.

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