Risk factors for surgical site infection in a teaching hospital: a prospective study of 1,138 patients

Keping, Cheng; Li, Jiawei; Kong, Qing; Wang, Changxian; Ye, Nanyuan; Xia, Guohua

doi:10.2147/ppa.s86153

Cited by 46 publications

(44 citation statements)

References 37 publications

(38 reference statements)

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“… 1 , 17 The association between increased age and occurrence of SSIs may be attributed to a decrease in physiological defense mechanisms and immune function. 18 , 19 Surgical wound classification has been recognized as a predictive factor in developing SSIs after surgery, and the incidence of SSI can be expected in patients with a higher surgical wound class. 19 …”

Section: Discussionmentioning

confidence: 99%

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Hamza¹,

Salama²,

Morsi³

et al. 2018

IDR

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PurposeTo measure surgical site infection (SSI) rates among gastrointestinal surgeries and to identify the associated risk factors.Patients and methodsWe conducted a multicenter, retrospective, surveillance-based study of adults undergoing gastric, colon, and small bowel (SB) procedures from January to December 2016. Univariate and multivariate analyses were conducted to determine the predictive variables in each surgery.ResultsIn total, 71 of 2,099 patients developed SSI – 0.8%, 19.8%, and 10.8% following gastric, colon, and SB surgeries, respectively. In gastric surgery, the risk factors identified by univariate analysis were age, duration, wound class, risk index, emergency, and scope use (P<0.05). Logistic regression analysis revealed that the laparoscopic approach was the only significant predictor, with an inverse relationship of SSI rate vs open gastric surgery (P<0.05). Prolonged duration was a significant risk factor for developing SSI in colon surgery, and emergency was a significant risk for development of SSI in SB surgery. Gram-negative bacilli were the main causative pathogens, with a high percentage of multidrug-resistant organisms.ConclusionVariances in SSI rates and risk factors among gastric, colon, and SB surgery were detected. The use of an endoscope in gastric surgeries exhibited a protective effect against the development of SSI. The reduction of the SSI rate can be achieved by targeted preventive interventions for the identified risk factors.

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Section: Discussionmentioning

confidence: 99%

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Hamza¹,

Salama²,

Morsi³

et al. 2018

IDR

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“…This finding is similar to the study by Oliveira et al, 14 who found no significant association between surgery type and SSI (p = 0.10). In contrast, a study of Cheng et al 15 showed a higher incidence of SSI in the emergency surgery group with a significant difference (p = 0.000). This study proposed that inadequate preoperative preparation of emergency surgeries may be responsible for such difference.…”

Section: Discussionmentioning

confidence: 67%

“…This showed that other factors must be evaluated alongside the surgical wound degree. 14 Cheng et al 15 evaluated risk factors of SSI in teaching hospitals. The study concluded that the degree of the surgical wound was independently associated with SSI after multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Our study involves population with comorbid tuberculosis which must receive tuberculosis treatment before surgery. 14,15 The difference in results could also be due to the difference in the classification of surgical wound degrees. Chan et al, 16 conducted a study on interrater reliability between surgeons, Swissnoso-trained infection clinical nurse (ICN), and histological findings in classifying surgical wound degrees in appendicitis.…”

Section: Discussionmentioning

confidence: 99%

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Association Between the Adequacy of Preoperative Antituberculosis Treatment with Abdominal Postoperative Morbidity and Mortality on Tuberculosis Patients

Anshori¹,

Putranto²

2019

nrjs

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Introduction. The adequacy of tuberculosis treatment before abdominal surgery is a dilemma faced by surgeons who aims for low risk of morbidity and mortality. In addition, there is no data on morbidity and mortality post abdominal operation on TB patients in RSCM and RS Persahabatan. Therefore, this research aims to show the correlation between the adequacy of preoperative TB treatment and postoperative morbidity (fistula enterocutaneous, obstruction, and surgical site infection) and mortality. Method. This study is a descriptive-analytic cross-sectional study done in Cipto Mangunkusumo Hospital dan Persahabatan Hospital using total sampling method, a total of 59 subjects with TB and had undergone abdominal operation and was admitted from January 2011 to August 2017, that fulfilled the criteria of this study. Bivariate and multivariate analysis using SPSS was done to analyze the correlation between TB treatment adequacy and postoperative morbidity and mortality. Results 46 subjects (78%) did not receive adequate preoperative TB treatment. The morbidity rate in this study is 29 subjects 49.25% with significant correlation with the adequacy of preoperative TB treatment (p = 0.030). From the three morbidities in this study (fistula enterocutaneous, obstruction, surgical site infection), only surgical site infection (SSI) has significant correlation with TB treatment adequacy (p = 0.048). There is no significant correlation with postoperative mortality (p = 0.564). Compared to elective surgery, emergency surgery has higher morbidity (OR = 1.62; 95% CI 0.58 -4.53) and SSI (OR = 2.02; 95% CI 0.63 -6.46) incidence. A significant difference in the incidence of SSI between clean and dirty surgery wound was found (p = 0.030). Multivariate analysis showed that both adequacy of antituberculosis treatment and surgery type are independent risk factors for morbidity (p = 0.025). Conclusion: Adequate preoperative TB treatment lowers the postoperative morbidity such as surgical site infection. There is no significant correlation between adequate preoperative TB treatment and mortality, and other morbidities such as fistula enterocutaneous and obstruction. Morbidity and SSI are more likely to happen in emergency surgery than elective surgery. Both adequacy of antituberculosis treatment and surgery type are independent risk factors for morbidity.

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“…Risk factors relating to the patient, procedure and the environment also alter the odds of developing an SSI. Research has been done to identify risk factors for SSI with the hope that it will lead to preemptive action to reduce the incidence rate of SSI [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Risk factor identification and contribution to surgery-specific surgical site infection

Niekerk

Vos

Stein

et al. 2019

Preprint

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Background: To identify common risk factors for the future occurrence of SSI across digestive system surgical procedures, thoracic surgery and orthopaedic procedures and quantify what the marginal contribution of explaining the future occurrence of SSI is of risk factors specific to each group of surgeries. Methods: Retrospective data from serial point-prevalence studies, performed at the Erasmus MC University Medical Center, Rotterdam, The Netherlands were used, together with medical data, from 3.250 surgical procedures, during the period January 2013 to 29 June 2014. Common risk factors across three groups of surgical procedures were identified by scanning literature and univariate analysis. A multivariate forward-step logistic regression model was used to identify the marginal contribution of the risk factor specific to each group of surgical procedure using the increase in the Gini coefficient. Results: For digestive system surgical procedures, antibiotic use, temperature, smoking status, age, CRP, thrombocyte, during of surgery and surgical urgency are risk factors for SSI, where the last four were specific to the digestive system group of surgical procedures and increased the Gini coefficient by 9.5% (0.63 to 0.69). Preoperative length of stay, antibiotic use and Leukocyte are risk factors for orthopaedic surgical procedures. Temperature, age and the use of antibiotics were significant for thoracic surgical procedures. Conclusion: ASA class, body mass index (BMI), Preoperative length of stay, diabetes, antibiotic use, age, Leukocyte, temperature and smoking status as general risk factors common to digestive, orthopaedic and thoracic surgical procedures using existing literature and univariate logistic regression. Risk factors for SSI, specific to a surgical procedure group can increase the ability to explain the future occurrence of SSI by 9.5%. The models developed in this study can aid healthcare workers to improve preoperative counselling and help identify potentially modifiable risk factors.

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Risk factors for surgical site infection in a teaching hospital: a prospective study of 1,138 patients

Cited by 46 publications

References 37 publications

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Benchmarking for surgical site infections among gastrointestinal surgeries and related risk factors: multicenter study in Kuwait

Association Between the Adequacy of Preoperative Antituberculosis Treatment with Abdominal Postoperative Morbidity and Mortality on Tuberculosis Patients

Risk factor identification and contribution to surgery-specific surgical site infection

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