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Invited Commentary
July 2017

Targeting Surgical Site Infection–Reducing Bundles Selectively to At-Risk Colon Cancer Surgery Populations: Achieving Value in a MACRA World?

Author Affiliations
  • 1The Georgia Cancer Center, Augusta University, Augusta
JAMA Surg. 2017;152(7):690. doi:10.1001/jamasurg.2017.0506

Surgical site infections (SSIs), a vexing problem in colon surgery, increase morbidity and significantly increase the cost of care. In an elegant article in this issue of JAMA Surgery, Amri et al1 evaluate their patient population at a large tertiary care facility for patient and perioperative risk factors that may increase SSIs after colon cancer surgery.

The risk factors linked in this study to an increase in SSIs are smoking, alcohol abuse, type 2 diabetes, obesity, length of operation greater than 140 minutes, and open vs minimally invasive surgery. The overall incidence of SSIs in this study was 6.2%. The incidence correlated with the number of risk factors. Patients with 1 or less risk factors were 2.5 times less likely to develop an SSI, and those with 4 or more risk factors had a 2.7-fold increase of risk over baseline.

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