A Risk Model for Surgical Site Infection in the Gastric Cancer Surgery Using Data of 790 Patients

Ushiku, Hideki; Hosoda, Kei; Yamashita, Keishi; Katada, Natsuya; Kikuchi, Shiro; Tsuruta, Harukazu; Watanabe, Masahiko

doi:10.1159/000440703

Cited by 7 publications

(14 citation statements)

References 32 publications

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“…Several studies have reported risk factors for SSIs after gastrectomy, including male sex, chronic liver disease, longer surgical time, advanced age, a BMI of 25 kg/m 2 or higher, diabetes mellitus, blood loss, TG, and combined resection procedures. [ 6 , 7 , 9 , 10 , 19 ] Similarly, male sex and TG were also risk factors in our study. However, other factors did not show a statistically significant difference.…”

Section: Discussionsupporting

confidence: 76%

“…To date, the overall incidence of SSIs is about 10% to 20%, and infections account for nearly half of the causes of death after major abdominal surgery. [ 6 , 7 , 11 – 14 ] It is crucially important to determine all the SSI risk factors, especially those factors that are modifiable so that SSIs can be prevented.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 , 2 ] Radical resection is the method of first choice for the treatment of GC. [ 3 – 5 ] However, about 10% of patients worldwide get a surgical-site infection (SSI) after radical gastrectomy for GC, [ 6 , 7 ] which prolongs hospitalization, increases medical costs, reduces patients’ quality of life, and even causes death. [ 8 ] Thus, to date, SSI remains controversial among surgeons.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for surgical-site infections after radical gastrectomy for gastric cancer: a study in China

Qiao

Zheng²,

Jia

et al. 2020

Chinese Medical Journal

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Background About 10% of patients get a surgical-site infection (SSI) after radical gastrectomy for gastric cancer, but SSI remains controversial among surgeons. The aim of this study was to explore the risk factors for SSIs after radical gastrectomy in patients with gastric cancer to guide clinical therapies and reduce the incidence of SSI. Methods The study was a retrospective cohort study in patients who underwent radical gastrectomy for gastric cancer. SSI was defined in accordance with the National Nosocomial Infection Surveillance System. We evaluated patient-related and peri-operative variables that could be risk factors for SSIs. The Chi-squared test and logistic regression analysis were used to assess the association between these risk factors and SSI. Results Among the 590 patients, 386 were men and 204 were women. The mean age was 56.6 (28–82) years and 14.2% (84/590) of these patients had an SSI. Among them, incisional SSI was observed in 23 patients (3.9%) and organ/space SSI in 61 patients (10.3%). Multivariate logistic regression analysis identified sex (odds ratios [ORs] = 2.548, and 95% confidence interval [CI]: 1.268–5.122, P = 0.009), total gastrectomy (OR = 2.327, 95% CI: 1.352–4.004, P = 0.002), albumin level (day 3 after surgery) <30 g/L (OR = 1.868, 95% CI: 1.066–3.274, P = 0.029), and post-operative total parenteral nutrition (OR = 2.318, 95% CI: 1.026–5.237, P = 0.043) as independent risk factors for SSI. Conclusions SSI was common among patients after radical gastrectomy for gastric cancer. The method supporting post-operative nutrition and the duration of prophylactic antibiotics may be important modifiable influencing factors for SSI.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for surgical-site infections after radical gastrectomy for gastric cancer: a study in China

Qiao

Zheng²,

Jia

et al. 2020

Chinese Medical Journal

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“…Fatigue among physicians and surgical team members reportedly contributes to SSIs [ 34 ]. However, operative duration ≥ the T time was a risk factor for OS-SSI in the first study period and both SI-SSI and OS-SSI in the second study period, with varying mean operative durations.…”

Section: Discussionmentioning

confidence: 99%

“…Operative duration ≥ the T time is considered to reflect the surgeon’s skills and/or complexity of the surgery [ 34 ]. For example, gastrectomy is the most common gastrointestinal surgical procedure in Japan because of the high incidence of gastric cancer [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Differences in risk factors for surgical site infection between laparotomy and laparoscopy in gastrointestinal surgery

Utsumi

Yamada²,

Yamabe

et al. 2022

PLoS ONE

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Extensive gastrointestinal surgery surveillance data in Japan were analyzed to examine the differences in the risk factors for surgical site infection (SSI) between laparotomy and laparoscopic abdominal procedures. Surgical procedures investigated in the study were gastrectomy, cholecystectomy, colectomy, rectal resection, and appendectomy. A total of 32,629 patients were included in the study. The study participants were divided into two groups according to the year of surgery, 2003–2009 (first study period) and 2010–2015 (second study period), due to the increase in the number of laparoscopic surgeries in the second study period. The incidence of SSI was stratified by three SSI classifications (superficial incisional, deep incisional, and organ/space SSI). Multiple logistic regression analysis was performed to predict the risk factors for SSI. The percentage of laparoscopic surgeries performed has increased linearly since 2010. Patients in the second study period were significantly older and had a higher prevalence of SSI risk factors compared with those in the first study period. In addition, the predictive factors changed substantially in most surgical procedures between the two study periods. Wound class ≥ 3 was a ubiquitous risk factor for superficial incisional SSI (SI-SSI) and organ/space SSI (OS-SSI) in both open (laparotomy) and laparoscopic procedures in the first study period. Meanwhile, in the second study period, operative duration was a ubiquitous risk factor in both procedures. The risk factors for SI-SSI differed from those for OS-SSI in the five abdominal surgeries investigated in the study. Periodic examination of risk factors for SSI is recommended in an aging society.

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Update of risk factors for surgical site infection in clean-contaminated wounds after gastroenterological surgery: An analysis of 1,878 participants enrolled in 2 recent randomized control trials for the prevention of surgical site infection

Maemoto¹,

Noda²,

Ichida³

et al. 2023

Surgery

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A Risk Model for Surgical Site Infection in the Gastric Cancer Surgery Using Data of 790 Patients

Cited by 7 publications

References 32 publications

Risk factors for surgical-site infections after radical gastrectomy for gastric cancer: a study in China

Risk factors for surgical-site infections after radical gastrectomy for gastric cancer: a study in China

Differences in risk factors for surgical site infection between laparotomy and laparoscopy in gastrointestinal surgery

Update of risk factors for surgical site infection in clean-contaminated wounds after gastroenterological surgery: An analysis of 1,878 participants enrolled in 2 recent randomized control trials for the prevention of surgical site infection

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