Scoring system to predict the risk of surgical-site infection after colorectal resection2

Gervaz, Pascal; Bandiera-Clerc, Catherine; Buchs, Nicolas; Eisenring, Marie-Christine; Troillet, Nicolas; Perneger, Thomas; Harbarth, Stéphan Juergen

doi:10.1002/bjs.8656

Cited by 71 publications

(44 citation statements)

References 24 publications

(24 reference statements)

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“…This association has often been described in the colorectal surgery population [21, 34, 35], and it also favours other risk factors for SSI like the hyperglycaemia or hypothermia [33]. Given the capacity of this parameter to predict SSI, it was included as one of the components of the NNIS risk index.…”

Section: Discussionmentioning

confidence: 97%

Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery

Gomila-Grange

Carratalà

Camprubí

et al. 2017

Antimicrob Resist Infect Control

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BackgroundOrgan-space surgical site infections (SSI) are the most serious and costly infections after colorectal surgery. Most previous studies of risk factors for SSI have analysed colon and rectal procedures together. The aim of the study was to determine whether colon and rectal procedures have different risk factors and outcomes for organ-space SSI.MethodsA multicentre observational prospective cohort study of adults undergoing elective colon and rectal procedures at 10 Spanish hospitals from 2011 to 2014. Patients were followed up until 30 days post-surgery. Surgical site infection was defined according to the Centers for Disease Control and Prevention criteria. Oral antibiotic prophylaxis (OAP) was considered as the administration of oral antibiotics the day before surgery combined with systemic intravenous antibiotic prophylaxis.ResultsOf 3,701 patients, 2,518 (68%) underwent colon surgery and 1,183 (32%) rectal surgery. In colon surgery, the overall SSI rate was 16.4% and the organ-space SSI rate was 7.9%, while in rectal surgery the rates were 21.6% and 11.5% respectively (p < 0.001). Independent risk factors for organ-space SSI in colon surgery were male sex (Odds ratio -OR-: 1.57, 95% CI: 1.14–2.15) and ostomy creation (OR: 2.65, 95% CI: 1.8–3.92) while laparoscopy (OR: 0.5, 95% CI: 0.38–0.69) and OAP combined with intravenous antibiotic prophylaxis (OR: 0.7, 95% CI: 0.51–0.97) were protective factors. In rectal surgery, independent risk factors for organ-space SSI were male sex (OR: 2.11, 95% CI: 1.34–3.31) and longer surgery (OR: 1.49, 95% CI: 1.03–2.15), whereas OAP with intravenous antibiotic prophylaxis (OR: 0.49, 95% CI: 0.32–0.73) was a protective factor. Among patients with organ-space SSI, we found a significant difference in the overall 30-day mortality, being higher in colon surgery than in rectal surgery (11.5% vs 5.1%, p = 0.04).ConclusionsOrgan-space SSI in colon and rectal surgery has some differences in terms of incidence, risk factors and outcomes. These differences could be considered for surveillance purposes and for the implementation of preventive strategies. Administration of OAP would be an important measure to reduce the OS-SSI rate in both colon and rectal surgeries.

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Section: Discussionmentioning

confidence: 97%

Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery

Gomila-Grange

Carratalà

Camprubí

et al. 2017

Antimicrob Resist Infect Control

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“…In the literature, the SSI rates in colon surgery varied from 3.5 to 21.3%, and are pointed as the largest SSI rates among elective procedures (5)(6)(7)(8)(9)(10)(11) . But diagnosing SSI only during hospital stay has not provided actual rates, which may underestimate the real values, as shown in a national study that notified 75% of SSI during post-discharge surveillance (10) .…”

Section: Introductionmentioning

confidence: 99%

“…For the factors related to the surgical procedure, the most prevalent were: long surgeries (time > 240 min), surgery classification according to the potential for contamination and open surgical approach (5)(6)(7)(8)(9)(10) .…”

Section: Introductionmentioning

confidence: 99%

Surgical site infection and its risk factors in colon surgeries

Fusco

Massarico

Alves

et al. 2016

Rev. esc. enferm. USP

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Objective:To identify the occurrence of surgical site infection (SSI) and its risk factors in patients undergoing colon surgery in a tertiary hospital located in the countryside of the state of São Paulo. Method: Retrospective cohort study, with collection of information contained in the medical records of patients undergoing colon surgery in the period between January 2010 and December 2013. The studied variables were the possible risk factors related to the patient, to demographic characteristics and the surgical procedure. Results: In total, were evaluated 155 patients with an overall SSI incidence of 16.7%. A statistically significant association was found both in the univariate as in the multivariate analysis between the SSI and the following variables: male gender, Charlson index and mechanical bowel preparation. Conclusion: The understanding of health professionals about the factors that influence the incidence of SSI in colon surgery may contribute to the quality of care provided to surgical patients, from effective actions to minimize the risk of infections. DESCRIPTORSSurgical Wound Infection; Colorectal Surgery; Perioperative Nursing. Surgical site infection and its risk factors in colon surgeriesInfecção de sítio cirúrgico e seus fatores de risco em cirurgias de cólon Infección de sitio quirúrgico y sus factores de riesgo en cirugías de colon

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“…This was thought to be appropriate, although the relative contribution of each identified factor to the overall model was not equal because of the relatively qualitative nature of the proposed scoring system. Furthermore, such a system needs to be user-friendly to be clinically relevant [16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…A value of 0.5 corresponds to a score with no predictive power (predictive ability equals chance), and a value of 1.0 corresponds to a score with perfect discrimination. Values of 0.7 and higher are considered clinically useful [17]. All statistical analyses were carried out using SPSS, version 17.0 (SPSS, Chicago, IL, USA) for Windows.…”

Section: Discussionmentioning

confidence: 99%

Major perioperative complications in laparoscopic spleen-preserving total gastrectomy for gastric cancer: perspectives from a high-volume center

et al. 2015

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Scoring system to predict the risk of surgical-site infection after colorectal resection2

Abstract: A simple clinical score based on four preoperative variables was clinically useful in predicting the risk of SSI in patients undergoing colorectal surgery.

Cited by 71 publications

References 24 publications

Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery

Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery

Surgical site infection and its risk factors in colon surgeries

Major perioperative complications in laparoscopic spleen-preserving total gastrectomy for gastric cancer: perspectives from a high-volume center

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