Date of Conferral

2020

Degree

Ph.D.

School

Public Health

Advisor

German Gonzalez

Abstract

Healthcare-associated infections (HAIs) are an emerging public health threat. Every day in the United States, HAIs impact 1 in 31 hospitalized patients. Surgical site infections (SSIs) account for over 40% of all reported HAIs and have an increased risk for morbidity and mortality. Surgery associated with colon procedures present an increased risk for infection, morbidity, and mortality. There has been vast work to prevent colon SSIs; however, there remain areas for improvement and exploration. The main research question evaluated the relationship between maintaining perioperative normothermia and colon SSIs. Secondary research questions explored additional risk factors to include age, gender, obesity, and tobacco use. To understand the association, several theories were explored, including the germ theory, germ theory of management, and epidemiologic triad. A quantitative case control study consisting of adult surgical patients (> 18 years of age) was conducted using secondary data (n = 47) from an acute care Level 1 Trauma Center. Multiple logistic regression was used for statistical analysis. Findings suggest that obesity is a significant risk factor for the development of colon SSIs (p = 0.011, 95% CI 1.612, 41.786, OR 8.207). Furthermore, obesity confounds the relationship between maintaining perioperative normothermia and the development of a colon SSI (p = .041, OR 4.147, 95% CI 1.059, 16.246). Findings may be used to inform public health leaders and health care providers the need for early intervention to reduce the occurrence of colon SSIs and improve patient outcomes among high risk groups. The social change impact by promoting targeted prevention strategies involves a reduction in colon SSIs and associated patient mortality and morbidity, thereby improving population health.

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