Surgical Site Infection after Colon Surgery: National Healthcare Safety Network Risk Factors and Modeled Rates Compared with Published Risk Factors and Rates

Young, Heather; Knepper, Bryan; Moore, Ernest E.; Johnson, Jeffrey L.; Mehler, Phillip S.; Price, Connie S.

doi:10.1016/j.jamcollsurg.2012.01.041

Cited by 61 publications

(31 citation statements)

References 43 publications

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“…Although these rates were high, they were similar to these reported in previous studies [8, 21]. Data from surveillance systems in Europe an US vary widely [22, 23], being in most cases lower than ours, though post-discharge surveillance is not always performed.…”

Section: Discussionsupporting

confidence: 90%

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: Discussionsupporting

confidence: 90%

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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“…The factors associated with the surgical technique are the preoperative skin preparation, the length of the surgery, the use of open versus laparoscopic surgery, the creation or closure of an ostomy, the suture material used for fascial closure and the type of skin closure (12). It has been reported that the relevant factors associated with the patient's condition are the gender, BMI, ASA score, immunosuppression, smoking, wound classification, requirement for a blood transfusion, subcutaneous fat thickness and postoperative hyperglycemia (13).…”

Section: Discussionmentioning

confidence: 99%

Impact of perioperative probiotic treatment for surgical site infections in patients with colorectal cancer

Aisu

Tanimura

Yamashita

et al. 2015

Experimental and Therapeutic Medicine

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“…Patients undergoing colorectal procedures present a greater degree of postoperative complications when compared with patients undergoing other surgical procedures [4]. The most prevalent of these complications include surgical site infections, which have been associated with an increased postoperative length of stay, greater costs of care, and higher rates of readmission [5].…”

Section: Introductionmentioning

confidence: 99%

Body mass index predicts operative time in elective colorectal procedures

Saiganesh

Stein

Poggio

2015

Journal of Surgical Research

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Surgical Site Infection after Colon Surgery: National Healthcare Safety Network Risk Factors and Modeled Rates Compared with Published Risk Factors and Rates

Cited by 61 publications

References 43 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

Impact of perioperative probiotic treatment for surgical site infections in patients with colorectal cancer

Body mass index predicts operative time in elective colorectal procedures

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