A novel, validated risk score to predict surgical site infection after pancreaticoduodenectomy

Poruk, Katherine E.; Lin, Joseph; Cooper, Michol A.; He, Jin; Makary, Martin A.; Hirose, Kenzo; Cameron, John L.; Pawlik, Timothy M.; Wolfgang, Christopher L.; Eckhäuser, Frederic E.; Weiss, Matthew J.

doi:10.1016/j.hpb.2016.07.011

Cited by 43 publications

(32 citation statements)

References 35 publications

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“…Both, preoperative biliary obstruction and its endoscopic treatment by stent insertion carry an increased infectious risk. [ 7 , 22 , 23 ] It has been shown that endoscopic biliary interventions increase the risk for postoperative complications, in particular cholangitis and POPF. [ 24 , 25 ] Therefore, preoperative biliary stenting should only be performed in selected patients, such as jaundiced patients necessitating neoadjuvant chemotherapy or when biliary sepsis precludes the operation.…”

Section: Discussionmentioning

confidence: 99%

Surgical site infections after pancreatic surgery in the era of enhanced recovery protocols

et al. 2018

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Few data exist on risk factors (RF) for surgical site infections (SSI) among patients treated in an enhanced recovery after surgery (ERAS) pathway. This study aimed to assess RF for SSI after pancreas surgery in a non-ERAS group and an ERAS cohort.An exploratory retrospective analysis of all pancreas surgeries prospectively collected (01/2000–12/2015) was performed. RF for SSI were calculated using uni- and multivariable binary logistic regressions in non-ERAS and ERAS patients.Pancreas surgery was performed in 549 patients. Among them, 144 presented a SSI (26%). In the non-ERAS group (n = 377), SSI incidence was 27% (99/377), and RF for SSI were male gender and preoperative biliary stenting. Since 2012, 172 consecutive patients were managed within an ERAS pathway. Forty-five patients (26%) had SSI. On multivariable analysis no RF for SSI in the ERAS cohort was found. In the ERAS group, patients with a pathway compliance ≤70% had higher occurrence of SSI (30/45 = 67% vs. 7/127 = 6%, p < 0.001) and patients with and without SSI had similar median overall compliances (77%, IQR 71–80 vs. 80%, IQR 73–83, p = 0.097).In the non-ERAS cohort, male gender and preoperative biliary stenting were RF for SSI, whereas in the ERAS group no RF for SSI was found. In an ERAS pathway, having an overall compliance >70% might diminish the SSI rate.

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Section: Discussionmentioning

confidence: 99%

Surgical site infections after pancreatic surgery in the era of enhanced recovery protocols

et al. 2018

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“…Surgical-site infections (SSIs) complicate 2–5% of all surgical procedures, 8% of major abdominal procedures [ 24 – 27 ]. Despite multiple infection control initiatives and quality improvements, SSIs remain a major concern for reliable safe surgery [ 28 , 29 ]. The rate of SSI in this study was comparable with other studies [ 27 ].…”

Section: Prevalence Of Ssimentioning

confidence: 99%

Impact of lockdown for SARS-CoV-2 (COVID-19) on surgical site infection rates: a monocentric observational cohort study

et al. 2020

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“…• Risk factors reported in previous studies: body mass index ≧25 kg/m 2 [9,13,18], ASA classification grade ≧3 [12], duration of surgery [7,9,12,13,18,19], age ≧70 years [7,9,18], transfusion [9,17,18], neoadjuvant chemotherapy [16], preoperative biliary stent [12,16], smoking [18], preoperative and intraoperative poor glycemic control (preoperative HbA1c level ≧7.0%, intraoperative maximum serum glucose level ≧180 mg/dL) [18], and serum albumin level <3.5 g/dL [18].…”

Section: Multivariable Analysismentioning

confidence: 99%

“…Therefore, the surgical duration is long, and the procedure is highly invasive. Numerous studies have investigated the risk factors of surgical site infection in pancreaticoduodenectomy, and multiple risk factors (e.g., age, obesity, long surgical time, smoking, poor glycemic control, neoadjuvant chemotherapy, transfusion, biliary stent, and malnutrition) have been identified [3,7,9,[12][13][14][15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Perioperative and anesthetic risk factors of surgical site infection in patients undergoing pancreaticoduodenectomy: A retrospective cohort study

et al. 2020

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Background Surgical site infection is a major perioperative issue. The morbidity of surgical site infection is high in major digestive surgery, such as pancreaticoduodenectomy. The comprehensive risk factors, including anesthetic factors, for surgical site infection in pancreaticoduodenectomy are unknown. The aim of this study was to investigate the perioperative and anesthetic risk factors of surgical site infection in pancreaticoduodenectomy. Methods This was a retrospective cohort study conducted in a single tertiary care center. A total of 326 consecutive patients who underwent pancreaticoduodenectomy between January 2009 and March 2018 were evaluated. Patients who underwent resection of other organs were excluded. The primary outcome was the incidence of surgical site infection, based on a Clavien-Dindo classification of grade 2 or higher. Multivariable logistic regression analysis was performed to investigate the association between surgical site infection and perioperative and anesthetic factors. Results Of the 326 patients, 116 (35.6%) were women. The median age was 70 years (interquartile range; 64-75). The median duration of surgery was 10.9 hours (interquartile range; 9.5-12.4). Surgical site infection occurred in 60 patients (18.4%). The multivariable analysis revealed that the use of desflurane as a maintenance anesthetic was associated with a significantly lower risk of surgical site infection than sevoflurane (odds ratio, 0.503; 95% confidence interval [CI], 0.260-0.973). In contrast, the duration of surgery (odds ratio, 1.162; 95% CI, 1.017-1.328), cerebrovascular disease (odds ratio, 3.544; 95% CI, 1.326-9.469), and ischemic heart disease (odds ratio, 10.839; 95% CI, 1.887-62.249) were identified as significant risk factors of surgical site infection.

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A novel, validated risk score to predict surgical site infection after pancreaticoduodenectomy

Abstract: Background: Although pancreaticoduodenectomy (PD) outcomes have improved, complications

Cited by 43 publications

References 35 publications

Surgical site infections after pancreatic surgery in the era of enhanced recovery protocols

Surgical site infections after pancreatic surgery in the era of enhanced recovery protocols

Impact of lockdown for SARS-CoV-2 (COVID-19) on surgical site infection rates: a monocentric observational cohort study

Perioperative and anesthetic risk factors of surgical site infection in patients undergoing pancreaticoduodenectomy: A retrospective cohort study

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