Factors Affecting Surgical Site Infection Rates in Hepatobiliary Surgery

Işık, Özgen; Kaya, Ekrem; Sarkut, Pınar; Dündar, Halit Ziya

doi:10.1089/sur.2013.195

Cited by 34 publications

(61 citation statements)

References 16 publications

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“…[35,36] In hepatobiliary surgery, the presence of biliary drainage catheter preoperatively was also found to be a specific risk factor for postoperative SSIs. [37] In the present study, preoperative biliary drainage was not a risk factor indicating SSIs. We suppose that bacterial culture may be necessary to explode the real bile infection rate after biliary drainage and the preoperative bile infection caused by biliary drainage may be an independent risk factor indicating postoperative SSIs.…”

Section: Discussionmentioning

confidence: 41%

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Ding

Han³

et al. 2017

Medicine

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Surgical site infection (SSI) is one of the major morbidities after radical resection for perihilar cholangiocarcinoma (PHCC). This study aimed to clarify the risk factors and construct a nomogram to predict SSIs in patients with PHCC.A total of 335 consecutive patients who underwent hepatectomy combined with hepaticojejunostomy between January 2013 and December 2015 were analyzed retrospectively. SSIs, including incisional (superficial and deep) and space/organ infection, were defined according to the Centers for Disease Control and Prevention (CDC)'s National Nosocomial Infection Surveillance (NNIS) system. Risk factors associated with postoperative SSIs were analyzed by univariate and multivariate analyses. A nomogram was developed on the basis of results from the multivariate logistic model and the discriminatory ability of the model was analyzed.PHCC patients had higher organ/space SSI rate than incisional SSI rate after radical resection. Multivariate analysis showed that risk factors indicating postoperative overall SSIs (incisional and organ/space) included coexisting cholangiolithiasis [odds ratio (OR): 6.77; 95% confidence interval (95% CI): 2.40–19.11; P < .001], blood loss >1500 mL (OR: 4.77; 95% CI: 1.45–15.65; P = .010), having abdominal surgical history (OR: 5.85; 95% CI: 1.91–17.97; P = .002), and bile leakage (OR: 15.28; 95% CI: 5.90–39.62; P < .001). The β coefficients from the multivariate logistic model were used to construct the model for estimation of SSI risk. The scoring model was as follows: −4.12 +1.91 × (coexisting cholangiolithiasis = 1) + 1.77 × (having previous abdominal surgical history = 1) +1.56 × (blood loss >1500 mL = 1) + 2.73 × (bile leakage = 1). The discriminatory ability of the model was good and the area under the receiver operating characteristic (ROC) curve (AUC) was 0.851.In PHCC patients, there may be a relationship between postoperative SSIs and abdominal surgical history, coexisting cholangiolithiasis, bile leakage, and blood loss. The nomogram can be used to estimate the risk of postoperative SSIs in patients with PHCC.

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Section: Discussionmentioning

confidence: 41%

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Ding

Han³

et al. 2017

Medicine

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“…Several factors have been shown to be linked with SSI rate following general surgery across studies including open surgical approach, smoking status, insulin-dependent (Table 1). 13,28,30,[38][39][40][41][42][43][44] As an example, knowing that a patient has a clean-contaminated or contaminated wound may help guide a surgeon's preference for closure with a biologic prosthesis rather than synthetic mesh when reinforcement of the abdominal wall is necessary.…”

Section: Risk Factorsmentioning

confidence: 99%

“…21,102,103 Finally, closed suction drainage, whether placed in a subcutaneous or intra-abdominal location, should be used judiciously as regular use may be associated with an increased risk of infection. 40,68 Prophylactic antibiotic timing is a nationally mandated quality metric and the timing of administration of preincision antibiotics has been well studied. [104][105][106][107][108] The utility of prophylactic antibiotics in clean cases remains controversial.…”

Section: Wound Dressingsmentioning

confidence: 99%

Postoperative abdominal wound infection – epidemiology, risk factors, identification, and management

Azoury¹,

Farrow²,

Hu³

et al. 2015

CWCMR

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Surgical site infections (SSIs) complicate the postoperative course of a significant proportion of general abdominal surgical patients and are associated with excessive health care costs. SSIs increase postoperative morbidity and mortality, and may require hospital admission, intravenous antibiotics, and even surgical reintervention. Risks associated with SSIs are related to both host and perioperative factors. However, a vast majority of these infections are preventable. More recently, quality initiative programs such as American College of Surgeons National Surgical Quality Improvement Program are expanding their roles to help better monitor adherence to improvement measures. Indeed, standardizing preoperative antibiotic prophylaxis timing is perhaps the most persuasive example and this has been integral to reducing postoperative SSI rates. Herein, the authors provide an update on the epidemiology, risk factors, identification, and management of wound infections following abdominal surgery.

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“…Antibiotic use and CRP were identified as risk factors for digestive surgeries from the multivariate analysis, which were identified during the literature search for thoracic and orthopaedic surgeries, respectively. Antibiotic use and temperature were statistically significant for all three groups of surgeries and were included because of two studies regarding thoracic and digestive system surgeries, respectively [ 40 , 55 ].…”

Section: Resultsmentioning

confidence: 99%

Risk factors for surgical site infections using a data-driven approach

et al. 2020

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Objective The objective of this study was to identify risk factors for surgical site infection from digestive, thoracic and orthopaedic system surgeries using clinical and data-driven cut-off values. A second objective was to compare the identified risk factors in this study to risk factors identified in literature. Summary background data Retrospective data of 3 250 surgical procedures performed in large tertiary care hospital in The Netherlands during January 2013 to June 2014 were used. Methods Potential risk factors were identified using a literature scan and univariate analysis. A multivariate forward-step logistic regression model was used to identify risk factors. Standard medical cut-off values were compared with cut-offs determined from the data. Results For digestive, orthopaedic and thoracic system surgical procedures, the risk factors identified were preoperative temperature of ≥38°C and antibiotics used at the time of surgery. C-reactive protein and the duration of the surgery were identified as a risk factors for digestive surgical procedures. Being an adult (age ≥18) was identified as a protective effect for thoracic surgical procedures. Data-driven cut-off values were identified for temperature, age and CRP which can explain the SSI outcome up to 19.5% better than generic cut-off values. Conclusions This study identified risk factors for digestive, orthopaedic and thoracic system surgical procedures and illustrated how data-driven cut-offs can add value in the process. Future studies should investigate if data-driven cut-offs can add value to explain the outcome being modelled and not solely rely on standard medical cut-off values to identify risk factors.

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Factors Affecting Surgical Site Infection Rates in Hepatobiliary Surgery

Cited by 34 publications

References 16 publications

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Postoperative abdominal wound infection – epidemiology, risk factors, identification, and management

Risk factors for surgical site infections using a data-driven approach

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Factors Affecting Surgical Site Infection Rates in Hepatobiliary Surgery

Cited by 34 publications

References 16 publications

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Postoperative abdominal wound infection &ndash; epidemiology, risk factors, identification, and management

Risk factors for surgical site infections using a data-driven approach

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Postoperative abdominal wound infection – epidemiology, risk factors, identification, and management