A model to predict risk of postpartum infection after Caesarean delivery*

Moulton, Laura J.; Jelovsek, J. Eric; Lachiewicz, Mark; Chagin, Kevin; Goje, Oluwatosin

doi:10.1080/14767058.2017.1344632

Cited by 8 publications

(9 citation statements)

References 39 publications

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“…Asthma had a significantly increased risk of postoperative complications, which were superficial surgical site infections. History of asthma has been established as a risk factor for perioperative respiratory adverse events, 6 and multiple studies have demonstrated that history of asthma can be significantly associated with surgical site infections, [7][8][9] although causation remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Analysis of National Outcomes for Simple Versus Complex Nasal Dermoid Cyst Excision

Kalmar

Patel

Taylor

2020

Journal of Craniofacial Surgery

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Section: Discussionmentioning

confidence: 99%

Analysis of National Outcomes for Simple Versus Complex Nasal Dermoid Cyst Excision

Kalmar

Patel

Taylor

2020

Journal of Craniofacial Surgery

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“…17 There is interest in developing more complicated modeling for the prediction of infection following CD. 18 While the overall rate of infection in the setting of IUPC is low, there is a potential for its incorporation into more complex modeling to identify patients who would benefit from postoperative prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Pressure Catheter Use Is Associated with an Increased Risk of Postcesarean Surgical Site Infections

et al. 2019

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Objective This study aimed to determine if intrapartum placement of an intrauterine pressure catheter (IUPC) is associated with an increased rate of surgical site infections in women undergoing a cesarean delivery. Study Design This was a secondary analysis of the prospective observational Maternal–Fetal Medicine Units Network Vaginal Birth after Cesarean Registry. We compared patients with and without IUPC use. A multivariable logistic regression was performed to evaluate for an association between IUPC use and postcesarean surgical site infections. Results The study included 16,887 women: 7,441 with IUPC use and 9,446 without IUPC use. After adjustment for potential cofounders, IUPC use was associated with an increased risk of postcesarean infections compared with those without IUPC use (adjusted odds ratio: 1.28; 95% confidence interval: 1.10–1.50; p = 0.002). Conclusion IUPC use is associated with an increased risk of postcesarean surgical site infections. This supports the judicious use of IUPC for limited clinical indications and provides a potential area of focus for reduction in postcesarean infections.

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“…Имеются противоречивые сведения о влиянии назначения более высоких доз антибиотиков на инфекционные исходы, в связи с чем эта модель также может быть полезна в данной ситуации -с расчетом конкретного индивидуального риска с учетом нескольких факторов [2,7,13,22,24,38]. При повышении порога рассматривается возможность назначения дополнительной терапии или более тщательное наблюдение в послеоперационном периоде, что в случае порога принятия решения с риском от 5 до 55% должно быть более целесообразно и эффективно по сравнению с лечением или мониторингом всех пациенток с высоким риском без увеличения ложноположительных результатов.…”

Section: интерпретация результатов исследованияunclassified

“…Современные исследования подтверждают, что комплексные пред-, пери-и профилактические послеоперационные мероприятия, могут привести к снижению акушерской инфекции [1,5,10,[17][18][19][20][21]. Существуют определенные группы пациенток, подвергающихся значительно более высокому риску развития инфекционных осложнений, поэтому их выявление с реализацией мер по инфекционному контролю, по мнению большинства клиницистов, является наиболее рациональным [6,8,[22][23][24][25]. Эффективность профилактических мероприятий при воспалительных осложнениях пуэрперия значительно возрастает при их ранней диагностике или прогнозировании вероятности с учетом соответствующих факторов риска.…”

Section: Introductionunclassified

Model for Predicting Risk of Postpartum Purulent-Inflammatory Complications after Cesarean Section: Cohort Retrospective Study

Куценко

Боровиков

Magay

et al. 2023

Kuban. nauсh. med. vestnik

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Background. Relevance of the study is related to the lack of a unified strategy for determining the risk of infectious complications of puerperium. Currently, the specialists use the collected data from studies documenting the main factors of infection in a population or cohorts of postpartum women. However, accuracy of these factors is not established and prognosis could not be personalized. The paper analyzes significant risk factors for the infectious complications associated with cesarean section (C-Section) and develops a model for their prognosis and an individual assessment of the risk of postpartum infection in order to take timely preventive measures. Objective. To identify predictors of postpartum purulent-inflammatory complications after cesarean section, to evaluate their predictive value, and to develop a statistical model for determining the risk of their occurrence.Methods. The cohort retrospective study (January 2019 to January 2022) was conducted in four obstetric health facilities of Krasnodar and was focused on analysis of medical records. Anamnestic, clinical and laboratory data of all women after cesarean section delivery were collected. Model: a patient diagnosed with any infection associated with cesarean section within 42 days after delivery — postoperative suture infection, endometritis, peritonitis, thrombophlebitis, sepsis. Infections were grouped to carry out a single risk assessment with an internal validation test and to develop a multifactor logistic regression model. All analyses were conducted using version R 3.2.3 (SPSS Inc., Chicago, IL) and Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD).Results. Infection associated with cesarean section occurred in 2.50% of women (n = 548; 95% CI 2.6–3.5), suture disruption — in 0.59% (n = 129; 95%, CI 0.41–0.81), endometritis — 1.46% (n = 321; 95%, CI 1.15–1.94), peritonitis — 0.16% (n = 35; 95%, CI 0.11–0.20), thrombophlebitis 0.04% (n = 9; 95%, CI 0.01–0.05), sepsis 0.25% (n = 54; 95%, CI 0.15–0.35). The authors have identified 14 major variables with a high prognostic risk for the development of infectious complications of puerperium. The model differentiated women with and without purulent inflammatory complications of puerperium by internal validation (concordance index = 0.712, 95%, CI 0.672–0.755).Conclusion. The developed model can be used to accurately predict the risk of infectious complications after abdominal delivery and to identify high-risk patients. It ensures a differentiated approach with a possibility to expand studies and strengthen antibiotic therapy, which promotes reduction of surgical site puerperal infection.

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A model to predict risk of postpartum infection after Caesarean delivery*

Cited by 8 publications

References 39 publications

Analysis of National Outcomes for Simple Versus Complex Nasal Dermoid Cyst Excision

Analysis of National Outcomes for Simple Versus Complex Nasal Dermoid Cyst Excision

Intrauterine Pressure Catheter Use Is Associated with an Increased Risk of Postcesarean Surgical Site Infections

Model for Predicting Risk of Postpartum Purulent-Inflammatory Complications after Cesarean Section: Cohort Retrospective Study

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