Risk Factors for Surgical Site Infections After Elective Gastrectomy

Migita, Kazuhiro; Takayama, Tomoyoshi; Matsumoto, Sohei; Wakatsuki, Kohei; Enomoto, Koji; Tanaka, Tetsuya; Ito, Masahiro; Nakajima, Yoshiyuki

doi:10.1007/s11605-012-1838-1

Cited by 29 publications

(52 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Without focused data collection, gastrectomy cases are not well represented among the larger population of complex abdominal cases and lack granular targeted-module data. Not surprisingly, and consistent with published data, surgical site infection and sepsis are the two most common metrics of NSQIP measured morbidity in this study (16). The organ space SSI of 7.05% is consistent with published rates of anastomotic leaks in recent literature ranging from 5 to 7%, however without targeted NSQIP data collection, the exact proportion of anastomotic leaks rather than other surgically-related causes of intra-abdominal infection cannot be defined precisely (17–20).…”

Section: Discussionsupporting

confidence: 92%

Morbidity and Mortality After Gastrectomy: Identification of Modifiable Risk Factors

Martin

Das

Turrentine

et al. 2016

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

Background Morbidity after gastrectomy remains high. The potentially modifiable risk factors have not been well described. This study considers a series of potentially modifiable patient-specific and perioperative characteristics that could be considered to reduce morbidity and mortality after gastrectomy. Methods This retrospective cohort study includes adults in the ACS NSQIP PUF dataset who underwent gastrectomy between 2011 and 2013. Sequential multivariable models were used to estimate effects of clinical covariates on study outcomes including morbidity, mortality, readmission and reoperation. Results 3,678 patients underwent gastrectomy. A majority of patients had distal gastrectomy (N= 2,799, 76.1%) and had resection for malignancy (N= 2,316, 63.0%). 798 patients (21.7%) experienced a major complication. Reoperation was required in 290 patients (7.9%). 30-day mortality was 5.2%. Age (OR=1.01, 95% CI: 1.01–1.02, p=0.001), preoperative malnutrition (OR=1.65, 95% CI: 1.35–2.02, p<0.001), total gastrectomy (OR=1.63, 95% CI: 1.31–2.03, p<0.001), benign indication for resection (OR=1.60, 95% CI: 1.29–1.97, p<0.001), blood transfusion (OR=2.57, 95% CI: 2.10–3.13, p<0.001), and intraoperative placement of a feeding tubes (OR=1.28, 95% CI: 1.00–1.62, p=0.047) were independently associated with increased risk of morbidity. Association between tobacco use and morbidity was statistically marginal (OR=1.23, 95% CI: 0.99–1.53, p=0.064). All-cause postoperative morbidity had significant associations with reoperation, readmission, and mortality (all p<0.001). Conclusions Mitigation of perioperative risk factors including smoking and malnutrition as well as identified operative considerations may improve outcomes after gastrectomy. Postoperative morbidity has the strongest association with other measures of poor outcome: reoperation, readmission, and mortality.

show abstract

Section: Discussionsupporting

confidence: 92%

Morbidity and Mortality After Gastrectomy: Identification of Modifiable Risk Factors

Martin

Das

Turrentine

et al. 2016

Journal of Gastrointestinal Surgery

View full text Add to dashboard Cite

show abstract

“…Age, BMI and gender are considered possible risk factors for postoperative complications [30][31][32][33] . The CHEMO and SURG groups did not differ significantly for one of these parameters ( table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of Neoadjuvant Chemotherapy on Postoperative Morbidity after Gastrectomy for Gastric Cancer

Téoule

Trojan²,

Bechstein³

et al. 2015

Dig Surg

View full text Add to dashboard Cite

Background/Aims: Patients with locally advanced gastric cancer benefit from neoadjuvant chemotherapy. Potential disadvantages of neoadjuvant chemotherapy include increased surgical complications, leading to increased postoperative morbidity. Methods: We retrospectively studied medical records of 135 patients with resectable cancer of the stomach who underwent gastrectomy between 2002 and 2009. The impact of neoadjuvant chemotherapy on postoperative morbidity was investigated. We compared demographic, clinical and operative data, morbidity and mortality from 105 patients who received surgical treatment immediately after diagnosis (SURG group), versus 30 patients who first received neoadjuvant chemotherapy (CHEMO group). Results: Demographic, clinical and surgical procedure parameters did not differ significantly between both groups. Postoperative morbidity was 46.7% in CHEMO- and 41.9% in SURG-patients (p = 0.680). There were eight cases of death, 2/30 (6.7%) in CHEMO and 6/105 (5.7%) in the SURG group (p = 1). The overall complications according to Clavien-classification did not differ significantly (p = 0.455). The wound infection rate (23.3 vs. 3.8%; p = 0.002) and insufficiency of the duodenal stump (13.3 vs. 1.9%; p = 0.022) were significantly higher in the CHEMO group. Conclusion: This study showed no significant impact of neoadjuvant chemotherapy on postoperative morbidity after gastrectomy using the Clavien-classification. Only an increase in wound infections in CHEMO compared with the SURG group were noted. Therefore, neoadjuvant chemotherapy can be considered safe and feasible.

show abstract

“…In the studies that described the strategies used for postoperative surveillance, the duration was 30 days or until discharge . Based on the surgical wound assessment in the hospital and phone calls and outpatient visits after discharge, health care personnel confirmed the diagnosis of SSI at various times, including eight, nine, or more than nine days after surgery …”

Section: Resultsmentioning

confidence: 99%

“…Most authors were physicians and the surgical procedures corresponded to four main areas: colorectal, [13][14][15][16][17][18][19] orthopedic, [20][21][22][23][24] head and neck, [25][26][27][28] and gynecological [29][30][31][32] surgeries. The studies also included cardiovascular surgery; 33,34 gastrectomy; 35 abdominal surgery, including pancreatectomy, total gastrectomy, and hepatic resection; 36 and a diverse sample, including general, vascular, and orthopedic surgeries. 37 The most common demographic data reported in the studies were age, [13][14][15][16][17][18][19][20][21]23,[30][31][32][33][34][35] sex, 13-28,33-37 body weight, 13,18 height, 21,23,24 or body mass index (BMI).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…37 The most common demographic data reported in the studies were age, [13][14][15][16][17][18][19][20][21]23,[30][31][32][33][34][35] sex, 13-28,33-37 body weight, 13,18 height, 21,23,24 or body mass index (BMI). 13,14,16,[19][20][21][22][25][26][27][29][30][31][32][33]35 The reported medical comorbidities included diabetes mellitus, 14 renal failure. 14,17,18,34,35,37 Smoking 13,16,17,25,26,[28][2...…”

Section: Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Perioperative Blood Transfusion and Occurrence of Surgical Site Infection: An Integrative Review

Mantoani¹,

Margatho²,

Dantas³

et al. 2019

AORN Journal

View full text Add to dashboard Cite

The aim of this integrative review was to locate, assess, and synthesize available evidence of the relationship between perioperative allogeneic blood transfusion and the occurrence of surgical site infection among adult patients undergoing elective surgery. After a comprehensive search of relevant databases and a review of the studies this yielded, we used a validated instrument to extract data from the 25 studies in our final sample. The clinical and surgical variables that were significantly and more frequently associated with the occurrence of surgical site infection among patients who received blood transfusions during the perioperative period were female sex, older age, and higher body mass index. Our findings indicate a lack of consensus on the hemoglobin levels that indicate a blood transfusion is necessary.

show abstract

Risk Factors for Surgical Site Infections After Elective Gastrectomy

Abstract: The risk factors both for incisional SSIs and for organ/space SSIs are strongly associated with surgical results. Meticulous surgical techniques are therefore required to prevent SSIs.

Cited by 29 publications

References 28 publications

Morbidity and Mortality After Gastrectomy: Identification of Modifiable Risk Factors

Morbidity and Mortality After Gastrectomy: Identification of Modifiable Risk Factors

Impact of Neoadjuvant Chemotherapy on Postoperative Morbidity after Gastrectomy for Gastric Cancer

Perioperative Blood Transfusion and Occurrence of Surgical Site Infection: An Integrative Review

Contact Info

Product

Resources

About