Search

The article offers information on the reports that aim to identify the health of American Indian and Alaska native (AI/AN) women, infants and children. The report entitled "Pregnancy Outcomes of American Indians: Contrasts Among Regions and With Other Ethnic Groups" by Dr. Greg Alexander underscores the importance of regional differences in AI/AN maternal risk factors and birth outcomes. Other reports include "American Indian Breastfeeding Attitudes and Practices in Minnesota," and "Ride Safe: A Child Passenger Safety Program for American Indian and Alaska Native Children" which add to the present fund of knowledge that relates to unacceptable health disparities and excess health risk among AI/AN.

The article presents a call for papers for the forthcoming supplement of the periodical "Maternal and Child Health Journal." Manuscripts may include epidemiologic studies, research on health services, intervention trials and program evaluations. Submission by American Indians and Alaskan Natives are encouraged.

Background: Despite adherence to the Centers for Medicare and Medicaid Services (CMS) core measures for preventing surgical site infections (SSI), our institution has a >10% rate of SSI after total abdominal hysterectomy (TAH), higher than the 90(th) percentile for SSI rates published in the 2009 National Healthcare Safety Network report., Methods: A retrospective chart review was performed for patients who underwent elective TAH at a public safety net hospital in Denver from December 30, 2005, to March 9, 2010. The primary outcome was development of SSI within 30 days. A secondary outcome was adherence to CMS core measures., Results: A total of 192 patients were included in the analysis, of whom 21 (10.9%) developed SSI. More than 95% had received antibiotics in the 60 min before surgical incision, and >90% received an appropriate antibiotic. Compliance with post-anesthesia care unit normothermia was equivalent in the SSI and non-SSI groups (81.0% vs. 75.2%; p=0.5588). Surgical site infection was associated with obesity (body mass index [BMI]≥30) (15.4% vs. 6.9%; p=0.0609), estimated blood loss≥500 mL (18.5% vs. 8.0%; p=0.0353), and receipt of a blood transfusion (28.6% vs. 10.5%; p=0.0183). In a multiple logistic regression model, obesity marginally increased the risk of SSI (odds ratio [OR] 2.55; 95% confidence interval [CI] 0.94-6.74), whereas blood transfusion was significantly associated with a higher risk of SSI (OR 3.58; 95% CI 1.21-10.62)., Conclusions: Blood transfusion was associated with SSI after TAH in our population. As it is a modifiable risk factor, larger multi-center studies are needed to confirm this result and determine appropriate transfusion thresholds.