EP962 - Do High Volume Surgeons Have Lower Surgical Site Infection Rates for Intrabdominal Surgery?

Tuesday, May 13, 2025

8:10 AM – 8:15 AM PT

ePoster Presenter(s)

Caroline E. Richburg, MD (she/her/hers)

General Surgery Resident
Yale-New Haven Hospital
New Haven, CT, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

Andrew C. Esposito, MD MHS (he/him/his)

General Surgery Resident
Yale-New Haven Hospital
New Haven, CT, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
CM

Clancy Mullan, MD

Cardiothoracic Surgery Resident
Yale-New Haven Hospital
New Haven, Connecticut, United States

Disclosure information not submitted.
DN

Donna F. Nucci, RN MS CIC

Director Infection Prevention
Yale New Haven Hospital
Old Saybrook, Connecticut, United States

Disclosure information not submitted.
VR

Vikram B. Reddy, MD, PhD, MBA

Chief of Colon and Rectal Surgery
Yale University School of Medicine
New Haven, Connecticut, United States

Disclosure information not submitted.

Senior Author(s)

JM

John Morton, MD, MPH

Professor and Vice Chair, Quality Improvement. Division Chief of Bariatric and MIS
Yale New Haven Hospital
New Haven, Connecticut, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Caroline E. Richburg, MD: This individual has no financial relationships with ineligible companies.

Andrew C. Esposito, MD MHS: This individual has no financial relationships with ineligible companies.

John Morton, MD, MPH: This individual has no financial relationships with ineligible companies.

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Purpose/Background: Purpose: Understand the relationship between an individual surgeon’s volume and surgical site infection (SSI) rate for intrabdominal surgery.

Background: In an effort to improve patient outcomes, there has been a national focus on decreasing SSI given the associated morbidity and cost. Prior work in this area has demonstrated reduced SSI rates at high-volume facilities. Additionally, work in other specialties has suggested a relationship between individual surgeon volume and SSI rates.

Methods/Interventions: As part of a larger effort to reduce deep/organ-space SSI at a large, multi-hospital academic health system, the time period of 1/1/2019 to 6/30/2024 was analyzed to evaluate the effect of surgeon volume on SSI rate. Data were collected and analyzed for all cases of intrabdominal surgery. This included the following specialties: colon and rectal surgery, general surgery, gynecology, and urology. Data were analyzed using Spearman’s rank correlation.

Results/Outcomes: Overall there were 10,525 intrabdominal surgeries performed with an average SSI of 4% during the indicated time period. The overall surgical site infection rate did not change from year to year with rates of 7% (2019), 5% (2020), 6% (2021), 5% (2022), 6% (2023), and 6% (2024). There was a significant inverse relationship between an individual’s surgical volume and SSI rate with an annual threshold volume at 50 cases, p < 0.0001, Spearman ρ = 0.488 (Figure 1).

Conclusion/Discussion: Higher-volume surgeons had fewer SSIs than lower-volume surgeons after cases involving bowel resection and anastomosis. This study supports prior research in other fields and suggests that high volume intrabdominal surgeons have lower SSI rates. This could also help explain the facility-level variations in SSI as partially-driven by individual surgeon volume.