To the Editor: The study by Dr Stulberg and colleagues1 affirmed the concern that, although SCIP has been a landmark step in translating evidence into measurement in surgery, the measures were based on many studies that used outcomes unadjusted for the risk of infection. Obesity alone may account for up to a 50% variation in postoperative infection rates.2 In addition, half of the SCIP measures involve antibiotics, which do not penetrate avascular areas prone to infection such as dead space in closed wounds and deep fluid collections.
Makary MA, Ibrahim AM. Surgical Care Improvement Project Adherence and Postoperative Infections. JAMA. 2010;304(15):1669-1672. doi:10.1001/jama.2010.1462