Could Quality Indicator Be a Reliable Marker of Preventing Surgical Site Infection in Colo-rectal Surgery? Analyzing Decade of Single-Center Experience

Surgical site infection (SSI) is a common post-operative complication in colo-rectal surgery. Antibiotic prophylaxis given in 1 h before incision was proved to decrease SSI rate. Quality measurement of choosing proper prophylactic antibiotics in colorectal surgery is a part of the National Program for Hospital Quality Indicators (NPHQI). We aimed to study change in complication rate in patients who underwent a colo-rectal surgery in the last decade in our Medical Center and evaluate the role of this quality indicator in the preventing of SSI. Medical records of all patients that were included in the quality measurement as defined by NPHQI, from 2012 to 2021, were reviewed. Database included demographics, surgical parameters, frequency of SSI, complication rate, and readmissions. SSI rate was compared to the quality measurements published by NPHQI. Overall, 1179 patients met the inclusion criteria. Overall complication rate was 26.7%. SSI developed in 14.8% of patients. Readmission required in 14% of patients. No decrease in SSI, overall complications, and readmission rates were observed during the study period. There was no correlation between the quality measurements and SSI rates. Prolonged time of surgery, open compared to laparoscopic procedure, and non-malignant pathology correlated to increased frequency of SSI. The quality indicator measuring the percentage of operations when prophylactic antibiotics were given in hour prior to surgical incision did not correlate with the rate of SSI, overall and severe complication rates, and readmissions.