Risk Factors of Surgical Site Infection after Hepatic Resection

Yang, Tian; Tu, Ping-An; Zhang, Han; Lü, Junhua; Shen, Yinan; Yuan, Shou-Xin; Lau, Wan Yee; Lai, Eric C. H.; Lu, Chongde; Wu, Mengchao; Li, Jiewei; Shen, Feng

doi:10.1086/675278

Cited by 19 publications

(19 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in multivariate analysis, hepatolithiasis was an independent risk factor indicating postoperative SSIs in patients with PHCC. Similarly, Yang et al [25] have shown that hepatolithiasis was an independent risk factor of both incisional and organ/space SSI after liver resection in 1 study including 7388 patients with different liver diseases. Cholangiolithiasis often resulted in bile infection and liver abscesses due to biliary obstruction, while preoperative hepatobiliary infection may be closely associated with postoperative SSIs.…”

Section: Discussionmentioning

confidence: 87%

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Ding

Han³

et al. 2017

Medicine

View full text Add to dashboard Cite

Surgical site infection (SSI) is one of the major morbidities after radical resection for perihilar cholangiocarcinoma (PHCC). This study aimed to clarify the risk factors and construct a nomogram to predict SSIs in patients with PHCC.A total of 335 consecutive patients who underwent hepatectomy combined with hepaticojejunostomy between January 2013 and December 2015 were analyzed retrospectively. SSIs, including incisional (superficial and deep) and space/organ infection, were defined according to the Centers for Disease Control and Prevention (CDC)'s National Nosocomial Infection Surveillance (NNIS) system. Risk factors associated with postoperative SSIs were analyzed by univariate and multivariate analyses. A nomogram was developed on the basis of results from the multivariate logistic model and the discriminatory ability of the model was analyzed.PHCC patients had higher organ/space SSI rate than incisional SSI rate after radical resection. Multivariate analysis showed that risk factors indicating postoperative overall SSIs (incisional and organ/space) included coexisting cholangiolithiasis [odds ratio (OR): 6.77; 95% confidence interval (95% CI): 2.40–19.11; P < .001], blood loss >1500 mL (OR: 4.77; 95% CI: 1.45–15.65; P = .010), having abdominal surgical history (OR: 5.85; 95% CI: 1.91–17.97; P = .002), and bile leakage (OR: 15.28; 95% CI: 5.90–39.62; P < .001). The β coefficients from the multivariate logistic model were used to construct the model for estimation of SSI risk. The scoring model was as follows: −4.12 +1.91 × (coexisting cholangiolithiasis = 1) + 1.77 × (having previous abdominal surgical history = 1) +1.56 × (blood loss >1500 mL = 1) + 2.73 × (bile leakage = 1). The discriminatory ability of the model was good and the area under the receiver operating characteristic (ROC) curve (AUC) was 0.851.In PHCC patients, there may be a relationship between postoperative SSIs and abdominal surgical history, coexisting cholangiolithiasis, bile leakage, and blood loss. The nomogram can be used to estimate the risk of postoperative SSIs in patients with PHCC.

show abstract

Section: Discussionmentioning

confidence: 87%

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Ding

Han³

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…Wound infection belongs in surgical site infection (SSI), which is the most common postoperative complication for hepatic resection 37 . Yang’s study 37 investigated the risk factors of SSI, and his results didn’t show a significant difference in incisional SSI when major resection (resection of 3 or more Couinaud liver segments) compared with minor resection (resection of fewer than 3 segments). However, MH and EH are both major resection, and our analysis result did show a higher wound rate in EH.…”

Section: Discussionmentioning

confidence: 99%

Mesohepatectomy Versus Extended Hemihepatectomies for Centrally Located Liver Tumors: A Meta-Analysis

Wang

Song

et al. 2017

Sci Rep

View full text Add to dashboard Cite

The comparison of Mesohepatectomy (MH) with conventional extended hemihepatectomies (EH) for patients with centrally located liver tumors (CLLTs) were inconsistent. Our aims were to systemically compare MH with EH and to determine whether MH can achieve a similar clinical outcome as EH through this meta-analysis. PubMed/Medline, EMBASE, Web of Knowledge and Cochrane Library were searched updated to June 11, 2016. Blood loss and operation time favored MH in elder patients (mean difference [MD] for blood loss: −692.82 ml, 95% CI: −976.72 to −408.92 ml, P < 0.001; MD for operation time: −78.75 min, 95% CI: −107.66 to −49.81, P < 0.001). Morbidity rate (29.2%, 95% CI: 24.1 to 34.8%), mortality rate (2.0%, 95% CI: 1.2 to 3.3%) and overall survival (median OS 38.2 m, 95% CI: 34.0 to 42.8 m) of MH were comparable with those of EH. The low liver failure rate favored MH (odds ratio [OR]: 0.29, 95% CI: 0.09 to 0.88, P = 0.03). For MH, bile leakage was the most common surgical complication (MH vs. EH: 13.5% vs. 6.7%, P = 0.016), while for EH, it was wound infection (MH vs. EH: 6.9% vs. 15.7%, P < 0.001). Thus MH might be in general safe and feasible for treating CLLTs with a similar clinical outcome as EH.

show abstract

“…Patient demographic information and peri‐operative factors known to influence the risk of post‐operative infection were also collected. These included: age, race, smoking status, body mass index, malignancy, diabetes, American Society of Anesthesiologists (ASA) physical status, surgical chemoprophylaxis data (type, timing and dose), operative time, blood loss during surgery, an intra‐operative red blood cell transfusion and open versus minimally invasive surgery …”

Section: Methodsmentioning

confidence: 99%

“…These included: age, race, smoking status, body mass index, malignancy, diabetes, American Society of Anesthesiologists (ASA) physical status, surgical chemoprophylaxis data (type, timing and dose), operative time, blood loss during surgery, an intra-operative red blood cell transfusion and open versus minimally invasive surgery. 7,[20][21][22][23][24][25][26][27][28][29][30] Statistical analysis Bivariate analyses of the association between each variable and exposure to pre-operative hospitalization using the Student's t, Pearson v 2 , and Wilcoxon's rank-sum tests as appropriate were performed. We used univariable logistic regression to calculate unadjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between pre-operative hospitalization and the risk of HAIs and SSIs in particular.…”

Section: Study Design and Patient Selectionmentioning

confidence: 99%

Prior inpatient admission increases the risk of post‐operative infection in hepatobiliary and pancreatic surgery

Dong

Chidi

Goswami

et al. 2015

HPB

View full text Add to dashboard Cite

show abstract

Risk Factors of Surgical Site Infection after Hepatic Resection

Cited by 19 publications

References 19 publications

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

A nomogram prediction of postoperative surgical site infections in patients with perihilar cholangiocarcinoma

Mesohepatectomy Versus Extended Hemihepatectomies for Centrally Located Liver Tumors: A Meta-Analysis

Prior inpatient admission increases the risk of post‐operative infection in hepatobiliary and pancreatic surgery

Contact Info

Product

Resources

About