Abstract
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.