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In a recent article in JAMA Surgery, Hawn and colleagues1 report a focused and statistically powerful assessment of outcomes related to measures in the Surgical Care Improvement Project (SCIP). The retrospective cohort study evaluated patient-level data on prophylactic antibiotic administration timing for 32 459 orthopedic, colorectal, vascular, and gynecologic procedures over 5 years and identified 1497 (4.6%) surgical site infections (SSIs). With unadjusted generalized additive models, a significant nonlinear relationship between prophylactic antibiotic administration timing and SSI was observed; however, when the generalized additive models were adjusted for the patient, procedure, and antibiotic variables, no significant association between timing of antibiotic administration and SSI was demonstrated. In an evaluation of the relative contributions of model covariates (including operation duration, age, diabetes, wound class, dyspnea, American Society of Anesthesiologists class, and chronic obstructive pulmonary disease), prophylactic antibiotic administration timing ranked 15th of 16 variables studied.
Seabrook GR. Does Rigorous Quality Process Reporting Guarantee Superior-Quality Health Care?. JAMA. 2013;310(3):316-317. doi:10.1001/jama.2013.7131