Multivariable Predictors of Postoperative Surgical Site Infection after General and Vascular Surgery: Results from the Patient Safety in Surgery Study

Neumayer, Leigh; Hosokawa, Patrick; Itani, Kamal M.F.; El‐Tamer, Mahmoud; Henderson, William G.; Khuri, Shukri F.

doi:10.1016/j.jamcollsurg.2007.03.022

Cited by 343 publications

(249 citation statements)

References 6 publications

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“…Numerous studies have supported associations with increased wound complications and surgical site infections in patients with complicated diabetes, peripheral vascular disease, and wound compromising medications [8,16,23,36,43,44,59]. Other comorbidities associated with increased risk of postoperative infection include obesity, malnutrition, tobacco use, and immunosuppressive medication [11,21,43,45]. Another potential cause for greater concern for surgical site infections after foot and ankle surgery is the persistent colonization of the forefoot despite preoperative preparation [7,12,30,47,48,63,65].…”

Section: Discussionmentioning

confidence: 99%

“…With modern operative technique, environment, and perioperative antibiotic prophylaxis, the association between infection and orthopaedic implants has decreased [13]. Some authors reported patient age to be an independent predictor for surgical site infections [43,45,59]. Wukich et al [64] did not find this association in 1000 patients undergoing foot and ankle procedures, nor have other studies [17,23,32,36,38,49].…”

Section: Discussionmentioning

confidence: 99%

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What are the Patterns of Prophylactic Postoperative Oral Antibiotic Use After Foot and Ankle Surgery?

Ruta

Kadakia

Irwin

2014

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What are the Patterns of Prophylactic Postoperative Oral Antibiotic Use After Foot and Ankle Surgery?

Ruta

Kadakia

Irwin

2014

Clinical Orthopaedics &Amp; Related Research

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“…26 Based on such risk factors, SSI prediction scores have been developed that allow the identification of patients at high risk for developing SSI. 5,7,8 For these high-risk patients, clinicians can implement appropriate prevention strategies and effective measures to diagnose infection and initiate therapy at an early stage. In addition, in the past few years, SSI surveillance systems have been shown to decrease the rates of SSI in various countries.…”

mentioning

confidence: 99%

Economic Burden of Surgical Site Infections at a European University Hospital

Weber

Zwahlen

Reck

et al. 2008

Infect. Control Hosp. Epidemiol.

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OBJECTIVE. To quantify the economic burden of in-hospital surgical site infections (SSIs) at a European university hospital.DESIGN. Matched case-control study nested in a prospective observational cohort study.SETTING. Basel University Hospital in Switzerland, where an average of 28,000 surgical procedures are performed per year.METHODS. All in-hospital occurrences of SSI associated with surgeries performed between January 1, 2000, and December 31, 2001, by the visceral, vascular, and traumatology divisions at Basel University Hospital were prospectively recorded. Each case patient was matched to a control patient by age, procedure code, and National Nosocomial Infection Surveillance System risk index. The case-control pairs were analyzed for differences in cost of hospital care and in provision of specialized care.RESULTS. A total of 6,283 procedures were performed: 187 SSIs were detected in inpatients, 168 of whom were successfully matched with a control patient. For case patients, the mean additional hospital cost was SwF19,638 (95% confidence interval [CI], SwF8,492-SwF30,784); the mean additional postoperative length of hospital stay was 16.8 days (95% CI, 13-20.6 days); and the mean additional in-hospital duration of antibiotic therapy was 7.4 days (95% CI, 5.1-9.6 days). Differences were primarily attributable to organ space SSIs (« = 76).CONCLUSIONS. Ina European university hospital setting, SSIs are costly and constitute a heavy and potentially preventable burden on both patients and healthcare providers. 2008; 29:623-629 Surgical site infections (SSIs) account for 14%-16% of all nosocomial infections in inpatients and are considered the most common form of nosocomial infection among surgical patients. 1 A number of risk factors have been associated with the onset of SSI, and they can be broadly subdivided into patientrelated characteristics (eg, greater age, poor nutritional status, and more numerous and/or more severe combrbid conditions) and surgery-related characteristics (eg, long duration of procedure, high wound classification, and absence of antibiotic prophylaxis). 26 Based on such risk factors, SSI prediction scores have been developed that allow the identification of patients at high risk for developing SSI. 5,7,8 For these high-risk patients, clinicians can implement appropriate prevention strategies and effective measures to diagnose infection and initiate therapy at an early stage. In addition, in the past few years, SSI surveillance systems have been shown to decrease the rates of SSI in various countries. 1 ' 916 In such systems, clinicians share feedback on infection rates with surgical staff and reinforce adherence to Centers for Disease Control and Prevention standards. A nosocomial infection surveillance system was introduced at Basel University Hospital in 1999 to decrease the rate of SSI. Infect Control Hosp EpidemiolNowadays, hospital infections, particularly SSIs-which are potentially preventable complications directly linked to surgery-are considered to reflect the quality of...

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“…Reported rates of infection vary from 0% to 19% in series ranging from 16 to 96 patients (Table 4). Numerous risk factors have been incriminated in the development of postoperative infection such as patients' comorbidities [28,33,34], previous surgery [36], complexity and duration of the operation [34,36], prophylactic antibiotic protocol [23,35,36], blood transfusion [28,33,35], radiation, and chemotherapy [8,21,23,35]. Our series shows possible increased susceptibility for allograft-prosthesis composites toward infection when compared with megaprostheses.…”

Section: Discussionmentioning

confidence: 83%

Results of 32 Allograft-prosthesis Composite Reconstructions of the Proximal Femur

Biau

Larousserie

Thévenin

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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The use of allograft-prosthesis composites for reconstruction after bone tumor resection at the proximal femur has generated considerable interest since the mid1980s on the basis that their use would improve function and survival, and restore bone stock. Although functional improvement has been documented, it is unknown whether these composites survive long periods and whether they restore bone stock. We therefore determined long-term allograft-prosthesis composite survival, identified major complications that led to revision, and determined whether allograft bone stock could be spared at the time of revision. We also compared the radiographic appearance of allografts sterilized by gamma radiation and fresh-frozen allografts. We retrospectively reviewed 32 patients with bone malignancy in the proximal femur who underwent reconstruction with a cemented allograft-prosthesis composite. The allograft-prosthesis composite was a primary reconstruction for 23 patients and a revision procedure for nine. The minimum followup was 2 months (median, 68 months; range, 2-232 months). The cumulative incidence of revision for any reason was 14% at 5 years (95% confidence interval, 1%-28%) and 19% at 10 years (95% confidence interval, 3%-34%). Nine patients (28%) had revision of the reconstruction during followup; four of these patients had revision surgery for infection. Allografts sterilized by gamma radiation showed worse resorption than fresh-frozen allografts. Based on reported results, allograft-composite prostheses do not appear to improve survival compared with megaprostheses.

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Multivariable Predictors of Postoperative Surgical Site Infection after General and Vascular Surgery: Results from the Patient Safety in Surgery Study

Cited by 343 publications

References 6 publications

What are the Patterns of Prophylactic Postoperative Oral Antibiotic Use After Foot and Ankle Surgery?

What are the Patterns of Prophylactic Postoperative Oral Antibiotic Use After Foot and Ankle Surgery?

Economic Burden of Surgical Site Infections at a European University Hospital

Results of 32 Allograft-prosthesis Composite Reconstructions of the Proximal Femur

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