Male Gender Is a Risk Factor for Major Infections After Surgery

Offner, Patrick J.

doi:10.1001/archsurg.134.9.935

Cited by 311 publications

(195 citation statements)

References 23 publications

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“…For example, women live longer than men; there is greater mortality for the top ten causes of death among males vs females; there is greater mortality among males due to addictions; and there is an increased risk of infection following trauma in males. [16][17][18][19] These results are consistent with our finding that males present for surgery with greater preoperative risk than females, as indicated by higher ASA scores, more comorbidities, and a higher incidence of emergent surgery. Moreover, these differences in preoperative risk factors accounted for a substantial proportion of the difference in postoperative mortality we observed between sexes.…”

Section: Discussionsupporting

confidence: 87%

Gender differences in mortality following non-cardiovascular surgery: an observational study

Grewal

Wijeysundera

Carroll

et al. 2011

Can J Anesth/J Can Anesth

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Section: Discussionsupporting

confidence: 87%

Gender differences in mortality following non-cardiovascular surgery: an observational study

Grewal

Wijeysundera

Carroll

et al. 2011

Can J Anesth/J Can Anesth

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“…Male sex was a risk factor for major infection, including SSI, after surgery in other studies. 21 ' 22 Reoperation and multiple surgical procedures were independent risk factors in this study. Reoperation is well known as a major predictor of tissue and wound complications, or SSI, in gastrointestinal surgery.…”

Section: Discussionmentioning

confidence: 57%

Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Kim

Song

et al. 2012

Infect. Control Hosp. Epidemiol.

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'" for the Korean Nosocomial Infections Surveillance System (KONIS)OBJECTIVE. To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea. DESIGN. A nationwide prospective multicenter study.SETTING. Twenty university-affiliated hospitals in Korea.METHODS. The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.RESULTS. Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 ( ± 12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. CONCLUSIONS. Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery. Infect Control Hosp Epidemiol 2012;33(6):572-580Surgical site infections (SSIs) are the leading cause of noslance system for nosocomial infections, the Korean Nosoocomial infection. The development of SSIs results in procomial Infections Surveillance System (KONIS), was devellonged hospital stay, extra costs, and increased morbidity and oped in Korea in 2006. 5 Gastric surgery was one of the most mortality. 1,2 A system for infection surveillance and to provide frequently performed surgical procedures in Korea in 2009 feedback to practicing surgeons regarding infection rates was (39.64 operations per 100,000 population); 6 when employing effective in reducing rates of SSI in previous studies. 3 ' 4 In surveillance for SSIs and risk factor analyses in Korea, gastric addition, it is important to establish the risk factors for SSI, surgery was given priority over other surgical procedures. A to prevent infectious complications after surgery by improvnumber of studies have shown that wound class, patient age, ing correctable factors.body mass index (BMI), duration of operation, laparoscopic A nationwide prospective multicenter Web-based surveilprocedure, and multiple doses of prophylactic antibiotics Affiliations:

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“…Clinical studies showed that males are at an increased risk for developing septic complications after traumatic injury and have increased mortality compared with females (37,47). The host's response and outcome after sepsis is, in large part, immune mediated.…”

Section: Discussionmentioning

confidence: 99%

Androgen-mediated modulation of macrophage function after trauma-hemorrhage: central role of 5α-dihydrotestosterone

Schneider

Schwacha

Samy

et al. 2003

Journal of Applied Physiology

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Androgens have been implicated as the causative factor for the postinjury immune dysfunction in males; however, it remains unknown whether androgens directly affect macrophages. To study this, male mice were sham operated or subjected to trauma (i.e., midline laparotomy) and hemorrhagic shock (mean arterial pressure, 30 ± 5 mmHg for 90 min and then resuscitated). The mice received the 5α-reductase inhibitor 4-hydroxyandrostenedione (4-OHA) before resuscitation. Plasma TNF-α, IL-6, and IL-10 levels were elevated after trauma-hemorrhage and normalized by 4-OHA. TNF-α and IL-6 production by splenic macrophages was decreased after injury, whereas Kupffer cell production of these mediators was enhanced. 4-OHA normalized cytokine production. Androgens suppressed cytokine production by splenic macrophages from hemorrhaged mice, whereas it enhanced TNF-α and IL-6 production by Kupffer cells. The addition of 4-OHA in vitro normalized cytokine production by cells treated with testosterone, but it had no effect on dihydrotestosterone-treated cells. These results indicate that androgens directly affect macrophage function in males after trauma and hemorrhagic shock and that the intracellular conversion of testosterone to dihydrotestosterone is of particular importance in mediating the androgen-induced effects.

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Male Gender Is a Risk Factor for Major Infections After Surgery

Cited by 311 publications

References 23 publications

Gender differences in mortality following non-cardiovascular surgery: an observational study

Gender differences in mortality following non-cardiovascular surgery: an observational study

Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Androgen-mediated modulation of macrophage function after trauma-hemorrhage: central role of 5α-dihydrotestosterone

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