Predictive factors of surgical site infection after hysterectomy for endometrial carcinoma: a retrospective analysis

Shi, Liyun; Gu, Qianqun; Zhang, Fenghua; Li, Daoyun; Ye, Wenfeng; Zhong, Yueyang; Shi, Xiu

doi:10.1186/s12893-021-01264-6

Cited by 11 publications

(8 citation statements)

References 37 publications

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“…Surgical site infection rates in patients after gynecological surgeries in different regions and hospitals vary according to data volume, surgical skills, and wound infection prevention and control measures [ 11 ]. Several studies have shown that surgical site infection rates in gynecological surgeries are 1–14.47% [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study from 2 Tertiary Hospitals in China to Evaluate the Risk Factors for Surgical Site Infections After Abdominal Hysterectomy in 188 Patients

et al. 2022

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Background Surgical site infections in patients after abdominal hysterectomy can increase medical expenses and increase the risk of death in patients. This retrospective study from 2 grade A tertiary hospitals in China aimed to evaluate the risk factors for postoperative surgical site infections (SSIs) in 188 patients undergoing abdominal hysterectomy between September 2013 and June 2021. Material/Methods Of the 188 patients, 94 patients with SSIs were classified into the infected group, and 94 patients without SSIs were classified into the control group. Wound drainage was sampled for bacterial isolation and culture. Results The suspected risk factors for SSIs after abdominal hysterectomy were body mass index, whether the patient had comorbidities of diabetes mellitus, cancer, or hypoproteinemia, surgical wound classification, whether preoperative skin preparation was performed, whether the patient had chemotherapy, length of incision, amount of blood loss during surgery, duration of surgery, necessity of a second surgery, whether a wound drainage tube was inserted, and whether delayed suturing was used in wound. Of them, body mass index (OR=1.133; 95% CI: 1.012~1.266; P =0.029), more than 3 hours of surgery (OR=0.261; 95% CI: 0.108~0.631; P =0.003), and wound drainage tube insertion (OR=0.223; 95% CI: 0.094~0.531; P =0.001) were the independent risk factors. Conclusions The findings support previous studies and showed that risk factors for SSIs after abdominal hysterectomy included increased patient BMI, increased operation duration, and the number of surgical drainage tubes used.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Study from 2 Tertiary Hospitals in China to Evaluate the Risk Factors for Surgical Site Infections After Abdominal Hysterectomy in 188 Patients

et al. 2022

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“…Expert judgment, extensive literature studies, and the availability of clinical data were used to select all possible candidate predictors for potential operative site infections in gynecologic oncology patients ( 5 – 9 ). The following candidate predictors were included in the study: general information [age, body mass index (BMI), season of admission, surgical history in recent 3 months, comorbidities, and the age-adjusted Charlson Comorbidity Index (aCCI)], preoperative variables [FIGO stage, ASA class, site of cancer, Barthel Index, Morse Fall Scale (MFS) score, preoperative steroid use, laboratory values, preoperative hair removal, preoperative length of stay (LOS), antibiotic prophylaxis within 0.5–1 h before operation, and the modified surgical complexity score (MSCS)], and intraoperative variables (surgical approach, operative time, estimated blood loss, blood transfusion, emergent surgery, and NNIS index).…”

Section: Methodsmentioning

confidence: 99%

“…On the basis of different inclusions of variables, we have developed three models to predict the potential operative site infections in a gynecologic oncology surgery:(a) candidate predictor for Model 1 was limited to only the NNIS risk index; (b) candidate predictors for Model 2 included all factors indicated in Table 1 except GNRI; (c) candidate predictors for Model 3 included all variables listed in Table 1 . To select the most optimal predictive features from the candidate predictors, the least absolute shrinkage and selection operator (LASSO) method was performed using the R package glmnet ( 9 ). This method is well-suited for reducing large datasets and reducing the likelihood of collinearity between the variables obtained from the same subject.…”

Section: Methodsmentioning

confidence: 99%

“…SSI is the outcome of a complex combination of factors relating to the patient, environment, and to the surgery itself ( 6 ). Recent studies have also shown and elucidated that nutritional status is also considered a critical factor that is closely associated with the development of SSI in gynecologic oncology patients ( 8 , 9 ). This suggests that the assessment of malnutrition could provide clinically valuable information regarding the prediction of SSI in gynecologic oncology patients.…”

Section: Introductionmentioning

confidence: 99%

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Development and Validation of a Nomogram Based on Geriatric Nutritional Risk Index to Predict Surgical Site Infection Among Gynecologic Oncology Patients

Chen

Zhong

et al. 2022

Front. Nutr.

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BackgroundThe geriatric nutritional risk index (GNRI) is a commonly used method to assess nutritional risk for predicting potential surgical site infections (SSI) in cancer patients. This study aims to create and verify a simple nomogram and a dynamic web-based calculator for predicting the risk of SSI among gynecologic oncology patients.MethodsA retrospective evaluation was conducted on patients who were admitted into a tertiary hospital in China with confirmed diagnosis of gynecologic cancer between 01 August 2017 and 30 November 2021. A two-piecewise linear regression model with a smoothing function was used to investigate the non-linear association between GNRI and SSI to determine the ideal cut-off point. Three models were developed on the basis of different variables to predict SSI in gynecologic oncology patients. Through a nomogram the concordance index (C-index), the Akaike information criterion (AIC), and the integrated discrimination index (IDI) were used to determine the final model. Finally, the performance of the nomogram was validated using the 1,000-bootstrap resamples method and analyzed using C-index, GiViTI calibration belts, and decision curve. Also, a user-friendly dynamic web-based calculator was developed.ResultsA total of 1,221 patients were included in the analysis. A non-linear association could be observed between GNRI and SSI risk with a GNRI cut-off value of 101.7. After adding GNRI to Model 2 (which comprised Morse Fall Scale score, preoperative length of stay, operation time, and estimated blood loss), the AIC value decreased, the C-index value increased and IDI increased significantly. The nomogram C-index in the development cohort and internal validation cohort demonstrates a moderate-high degree of discrimination. The GiViTI calibrated belt showed a good agreement between the observed and predicted probabilities of SSI. The decision curve validates the clinical feasibility of the nomogram with a threshold value between 0 and 49%.ConclusionThe GNRI cut-off value of 101.7 allowed for appropriate stratification of patients into distinct SSI risk groups. This study found that including GNRI in the above nomogram (Model 2) would enhance its potential to predict SSI in gynecologic oncology patients.

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“…Frailty has been connected to advancing age and has been demonstrated to increase postoperative complications and mortality following gynecologic surgery. Given that uterine corpus cancer is a common reason for hysterectomy, with an age-standardized rate of 12.9 per 100 000 women in rich nations, the additional burden on communities could be significant [5].…”

Section: Introductionmentioning

confidence: 99%

Surgical Site Infections in Gynaecological Surgeries

Iyengar

Nayyar

Jajoo

2021

JPRI

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Surgical contaminations are one of the utmost familiar medical management related contamination within the economically developing nations. Gynecologic tactics constitute a completely distinctive venture within which the infectious pathogen arising out of pores and the underlying skin or the vagina and endo-cervix can also relocate up to the area of surgery and may bring about vaginal cuff cellulitis, cellulitis of the pelvis, and abscesses of the pelvis. Numerous organisms along with operation threat elements were recognized as dangers that grow infectious sequelae after pelvic surgical treatment. The full-size use of antibiotic prophylaxis has decreased however now no longer removed severe postoperative infections; the common anticipated SSIs price being three–15% after c-section. Those costs are multiplied by the existence of various threat elements like surgical infection, which is compounded by untimely rupture of membranes, obstructed labour, chorioamnionitis, large obesity, extended duration of surgery, emergency surgeries, and immunodeficiency, all of that are not uncommon within aid-deficient nations. Other factors linked to physician ability, such as poor operation skills, insufficient hemostasis, and the presence of a useless region, lead to increased injury contamination. Working at the pinnacle, such as those medical conditions that occur during pregnancy and malnutrition, also contribute significantly to the problem. SSIs as the most common motive concerning hospital-acquired contamination in obstetrics, although the present contemporary era, remains as chief residence fitness hassle within growing nations. We may even evaluate the definitions, microbiology, pathogenesis, diagnosis, and control of pelvic SSIs after gynecologic surgical procedures.

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Predictive factors of surgical site infection after hysterectomy for endometrial carcinoma: a retrospective analysis

Cited by 11 publications

References 37 publications

A Retrospective Study from 2 Tertiary Hospitals in China to Evaluate the Risk Factors for Surgical Site Infections After Abdominal Hysterectomy in 188 Patients

A Retrospective Study from 2 Tertiary Hospitals in China to Evaluate the Risk Factors for Surgical Site Infections After Abdominal Hysterectomy in 188 Patients

Development and Validation of a Nomogram Based on Geriatric Nutritional Risk Index to Predict Surgical Site Infection Among Gynecologic Oncology Patients

Surgical Site Infections in Gynaecological Surgeries

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