{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:17:00Z","timestamp":1792718220775,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006034","name":"University of Southern California","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006034","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The goal of this study was to investigate factors associated with 30\u2010day readmission in a multivariate model, including the CDC wound classes \u201cclean,\u201d \u201cclean\/contaminated,\u201d \u201ccontaminated,\u201d and \u201cdirty\/infected.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The 2017\u20132020 American College of Surgeons\u2010National Surgical Quality Improvement Program (ACS\u2010NSQIP) database was queried for all patients undergoing total hip replacement, coronary artery bypass grafting, Ivor Lewis esophagectomy, pancreaticoduodenectomy, distal pancreatectomy, pneumonectomy, and colectomies. ACS\u2010defined wound classes were concordant with CDC definitions. Multivariate linear mixed regression was used to determine risk factors for readmission while adjusting for type of surgery as a random intercept.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>477,964 cases were identified, with 38,734 (8.1%) patients having experienced readmission within 30\u00a0days of surgery. There were 181,243 (37.9%) cases classified as wound class \u201cclean\u201d, 215,729 (45.1%) cases classified as \u201cclean\/contaminated\u201d, 40,684 cases (8.5%) classified as \u201ccontaminated\u201d, and 40,308 (8.4%) cases classified as \u201cdirty\/infected\u201d. In the multivariate generalized mixed linear model adjusting for type of surgery, sex, body mass index, race, American Society of Anesthesiologists class, presence of comorbidity, length of stay, urgency of surgery, and discharge destination, \u201cclean\/contaminated\u201d (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), \u201ccontaminated\u201d (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and \u201cdirty\/infected\u201d (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) wound classes (when compared to \u201cclean\u201d) were significantly associated with 30\u2010day readmission. Organ\/space surgical site infection and sepsis were among the most common reasons for readmission in all wound classes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Wound classification was strongly prognostic for readmission in multivariable models, suggesting that it may serve as a marker of readmissions. Surgical procedures that are \u201cnon\u2010clean\u201d are at significantly greater risk for 30\u2010day readmission. Readmissions may be due to infectious complications; optimizing antibiotic use or source control to prevent readmission are areas of future study.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07093-3","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T12:02:38Z","timestamp":1688558558000},"page":"2392-2400","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Centers for Disease Control (CDC) Wound Classification is Prognostic of 30\u2010Day Readmission Following Surgery"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5072-9903","authenticated-orcid":false,"given":"Victoria","family":"Yin","sequence":"first","affiliation":[{"name":"Keck School of Medicine University of Southern California 1975 Zonal Avenue 90033 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Perren","family":"Cobb","sequence":"additional","affiliation":[{"name":"Departments of Surgery &amp; Anesthesiology Critical Care Institute Keck School of Medicine University of Southern California 1520 San Pablo Street, Suite 4300 90033 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean C.","family":"Wightman","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Department of Surgery Keck School of Medicine University of Southern California 1510 San Pablo Street, Suite 514 90033 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott M.","family":"Atay","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Department of Surgery Keck School of Medicine University of Southern California 1510 San Pablo Street, Suite 514 90033 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Harano","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Department of Surgery Keck School of Medicine University of Southern California 1510 San Pablo Street, Suite 514 90033 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony W.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Department of Surgery Keck School of Medicine University of Southern California 1510 San Pablo Street, Suite 514 90033 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.07.012"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.11.048"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1303118"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0195941700064080"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2016.07.010"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2021.08.679"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2013.40.5.522"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2011.05.056"},{"key":"e_1_2_9_10_1","unstructured":"User Guide for the 2012 ACS NSQIP Participant Use Data File.https:\/\/www.facs.org\/media\/kanfv4dl\/ug12.pdf"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOSGlobal\u2010D\u201017\u201000022"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/hpb.12275"},{"key":"e_1_2_9_13_1","unstructured":"National Surgical Quality Improvement Program. 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