Emergency Surgery Score Accurately Predicts the Risk of Post-Operative Infection in Emergency General Surgery

Han, Kelsey; Lee, Jae Moo; Achanta, Aditya; Kongkaewpaisan, Napaporn; Kongwibulwut, Manasnun; Eid, Ahmed; Kokoroskos, Nikolaos; Wijck, Suzanne F M Van; Meier, Karien; Nordestgaard, Ask Tybjærg; Rodriguez, Gilhen; Jia, Zhiying; King, David R.; Fagenholz, Peter J.; Saillant, Noelle; Mendoza, April E.; Rosenthal, Martin; Velmahos, George C.; Kaafarani, Haytham M.A.

doi:10.1089/sur.2018.101

Cited by 31 publications

(16 citation statements)

References 16 publications

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“…Several predictive risk scores of acquiring postoperative infection have been constructed in different surgical settings with AUC between 0.63 and 0.82. AUCs of the risk scores for surgical site infection (SSI) complicating coronary artery bypass graft surgery were 0.63; 10 for cardiac implantable electronic devices infection were 0.79; 7 and for postoperative infection, postoperative sepsis/septic shock, and pneumonia in the emergency general surgery patients were 0.73, 0.75, and 0.80, respectively, 8 and the AUC for deep sternal wound infection after bilateral internal thoracic artery grafting was 0.82 9 . This scoring system needs further evaluation to validate clinically, especially in certain cases such as SSI and infections with MDR bacteria that necessitate specific antibacterial regimens.…”

Section: Discussionmentioning

confidence: 99%

“…The predictive score, by way of analyzing simple clinical variables in high‐risk patients, could help with timely start of appropriate antibiotic therapy and/or selecting patients for more intense prophylactic regimen. Although such scoring systems have been reported in different surgical settings, 7–10 no predicting score system for LT has been proposed yet.…”

Section: Introductionmentioning

confidence: 99%

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Bacterial infections in the early period after liver transplantation in adults: A prospective single‐center cohort study

Jafarpour

Pouladfar

Malek-Hosseini

et al. 2020

Microbiology and Immunology

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Liver transplantation (LT) is a potentially curative treatment for terminal stage hepatic diseases. Bacterial infections are the main causes of mortality and morbidity in the early period after LT. Identifying the risk factors could help in minimizing their development. We prospectively investigated the incidence, characteristics, and risk factors of bacterial infections among the recipients during hospitalization after LT and assigned a predictive score. All 389 consecutive adults who underwent LT at the main referral hospital of LT in Iran during 1 year were enrolled prospectively in a cohort study. Infection group consisted of 143 recipients (36.8%). Urinary tract and surgical site infections were the most frequent ones. Gram-negative bacteria were more prevalent than Gram-positive ones. Independent risk factors were female sex (relative risks = 2.13), age ≤ 43.5 years (3.70), hospital stay ≥ 9.5 days (5.22), abdominal reoperation (3.03), vancomycin-resistant Enterococci colonization (5.52), hospitalization 3 months prior to LT (3.25), mechanical ventilation ≥48 hr (4.93), and renal replacement therapies (13.40). We developed a risk score for the prediction of bacterial infections with an area under the receiver operating characteristic curve of 0.85 (95% CI, 0.81-0.89) with sensitivity of 88% and specificity of 64%. In the infection group, mortality was higher than in controls (18.9% vs. 2.0%) with longer hospitalization (16 vs. 10 days; P < 0.001). We detected a high rate of bacterial infections leading to longer hospital stay and higher mortality rate. The formulated risk score can help predict bacterial infections; however, it requires clinical validation in further studies. K E Y W O R D S bacterial infections, Iran, liver transplantation, risk factors, scoring systems ---Abbreviations: AUC, area under the curve; CRRT, continuous renal replacement therapy; LT, liver transplantation; MDR, multidrug resistance; MELD, model for end-stage liver disease; ROC curve, receiver operating characteristic curve. | RESULTSDuring the study period, 399 LTs were performed on 389 adult patients. Ten (2.6%) patients received two transplants each: seven for post-transplant complications, two 408 | JAFARPOUR ET AL.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bacterial infections in the early period after liver transplantation in adults: A prospective single‐center cohort study

Jafarpour

Pouladfar

Malek-Hosseini

et al. 2020

Microbiology and Immunology

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“…In our review, researchers observed the highest incidence of SSI in patients undergoing emergent posttraumatic surgical interventions 27 . During emergent trauma laparotomies, contaminated open wounds, the critical state of the patient, and the inability to control factors such as blood loss or procedure duration may have led to SSI development 45,46 …”

Section: Discussionmentioning

confidence: 93%

The Role of Perioperative Hypothermia in the Development of Surgical Site Infection: A Systematic Review

Cengiz¹,

Uçar²,

Yilmaz³

2021

AORN Journal

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Surgical patients may experience inadvertent perioperative hypothermia, a condition that can cause a variety of complications, including surgical site infection (SSI). The authors of this systematic review used the Preferred Reporting Items for Systematic Review and Meta‐Analysis Protocols guidelines to examine the role of perioperative hypothermia in the development of SSI. The authors searched the PubMed, Cumulative Index Nursing and Allied Health Literature, Cochrane, and ScienceDirect databases for eligible articles published between January 2008 and November 2018 and identified seven studies that met the inclusion criteria. The results of this review indicate that the relationship between hypothermia and SSI is closely related to the type of the surgical intervention performed (eg, emergent, colorectal), and that severe hypothermia (eg, <35.0° C [95.0° F]) can increase the risk of developing an SSI. Perioperative nurses should monitor patients for inadvertent hypothermia and prevent its occurrence when possible.

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“…Emergency surgery should be only indicated if all following conditions are met: the patient's physical condition can tolerate surgical treatment, the patient exhibits unstable vital signs, the injury exhibits progressive aggravation, and non-surgical treatment cannot stabilize the condition. 17 In cases with infected diabetic foot ulcers, local abscesses, a severe inflammatory reaction, or even septic shock, local treatment is urgently required for drainage and control of systemic infection. Patients with irreversible necrosis of the limbs, progressive infection, toxin absorption leading to severe liver and kidney dysfunction, or septic shock, and those in whom non-surgical treatment failed, require emergency amputation surgery as a life-saving measure.…”

Section: Management Of Patients Without Covid-19 Who Have Dfusmentioning

confidence: 99%

Surgical treatment of diabetic foot ulcers during the COVID-19 pandemic in China

Tao

Tang

Hai

et al. 2020

Journal of Diabetes and its Complications

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Diabetic foot ulcers are among the most serious complications of diabetes. If left untreated, these ulcers can lead to severe infection and gangrene; in some instances, they may result in death. Thus, timely treatment of diabetic foot ulcers is extremely important. However, timely patient treatment during the COVID-19 pandemic is particularly challenging, because of the higher volume of patients and the need to ensure safety of medical personnel. This article describes a proposed strategy for diagnosis and treatment of diabetic foot ulcers, based on experiences with infection and control strategies during the COVID-19 pandemic in China.

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Emergency Surgery Score Accurately Predicts the Risk of Post-Operative Infection in Emergency General Surgery

Cited by 31 publications

References 16 publications

Bacterial infections in the early period after liver transplantation in adults: A prospective single‐center cohort study

Bacterial infections in the early period after liver transplantation in adults: A prospective single‐center cohort study

The Role of Perioperative Hypothermia in the Development of Surgical Site Infection: A Systematic Review

Surgical treatment of diabetic foot ulcers during the COVID-19 pandemic in China

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