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Background <p>Air changes per hour (ACH) in operating rooms (ORs) are energy intensive, and optimal air change settings are not known.</p> Objectives <p>We sought to explore whether there is a relationship between surgical site infections (SSIs) across states based on their state-mandated ACHs.</p> Design <p>Ecological, descriptive, cross-sectional study of publicly reported SSI data in the United States.</p> Methods <p>Wilcoxon test was used to investigate differences between SSI rates for specific surgery types between ACH mandate levels (15 and 20 ACH). Uni- and multivariable Poisson models at the state level were fitted to estimate differences in SSI rates for each surgery type.</p> Results <p>OR ACH mandates and SSIs were positively correlated for C-sections and spinal fusion; negatively correlated for colon and laminectomy surgery.</p> Conclusion <p>For most surgery types, there is no correlation between state-mandated OR ACH. Further studies are needed to determine what changes to mandates can be made safely and effectively.</p>

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Differences in surgical site infection rates by state according to state-mandated operating room air changes per hour

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月8日

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  • Andrew Atkinson,
  • Jonas Marschall,
  • Jason P. Burnham

摘要

Background

Air changes per hour (ACH) in operating rooms (ORs) are energy intensive, and optimal air change settings are not known.

Objectives

We sought to explore whether there is a relationship between surgical site infections (SSIs) across states based on their state-mandated ACHs.

Design

Ecological, descriptive, cross-sectional study of publicly reported SSI data in the United States.

Methods

Wilcoxon test was used to investigate differences between SSI rates for specific surgery types between ACH mandate levels (15 and 20 ACH). Uni- and multivariable Poisson models at the state level were fitted to estimate differences in SSI rates for each surgery type.

Results

OR ACH mandates and SSIs were positively correlated for C-sections and spinal fusion; negatively correlated for colon and laminectomy surgery.

Conclusion

For most surgery types, there is no correlation between state-mandated OR ACH. Further studies are needed to determine what changes to mandates can be made safely and effectively.