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Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection

BACKGROUND: Patients with Crohn’s disease (CD) are often reported to be at a high risk for incisional surgical site infection (SSI). The aim of this study was to identify the risk factors associated with post-operative incisional SSI in CD patients after bowel resection. METHOD: CD patients undergoi...

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Autores principales: Hu, Tuo, Wu, Xianrui, Hu, Jiancong, Chen, Yufeng, Liu, Huashan, Zhou, Chi, He, Xiaowen, Zhi, Min, Wu, Xiaojian, Lan, Ping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101509/
https://www.ncbi.nlm.nih.gov/pubmed/30151203
http://dx.doi.org/10.1093/gastro/goy007
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author Hu, Tuo
Wu, Xianrui
Hu, Jiancong
Chen, Yufeng
Liu, Huashan
Zhou, Chi
He, Xiaowen
Zhi, Min
Wu, Xiaojian
Lan, Ping
author_facet Hu, Tuo
Wu, Xianrui
Hu, Jiancong
Chen, Yufeng
Liu, Huashan
Zhou, Chi
He, Xiaowen
Zhi, Min
Wu, Xiaojian
Lan, Ping
author_sort Hu, Tuo
collection PubMed
description BACKGROUND: Patients with Crohn’s disease (CD) are often reported to be at a high risk for incisional surgical site infection (SSI). The aim of this study was to identify the risk factors associated with post-operative incisional SSI in CD patients after bowel resection. METHOD: CD patients undergoing bowel resection between 2007 and 2015 were enrolled. Demographic and clinical features related to post-operative incisional SSI were analysed using both univariate and multivariate logistical analyses. RESULTS: Of all eligible patients (n = 159), 123 (77.4%) were male, with a mean age at surgery of 33.4 ± 11.8 years. A total of 35 (22.0%) CD patients developed post-operative incisional SSI. Post-operative incisional SSI was more likely to happen in patients who had penetrating type of disease (P = 0.018), underwent bowel resection for the indication of chronic fistula (P = 0.005) and had an intra-operative finding of fistula (P = 0.001). A greater proportion of patients with post-operative incisional SSI were found to have anemia (P = 0.019) but elevated levels of white blood cells (P = 0.027), neutrophils (P = 0.006) as well as an elevated percentage of neutrophils (P = 0.005). Multivariate logistic regression analysis showed that anemia (odds ratio [OR]: 3.31, 95% confidence interval [CI]: 1.05–10.46, P = 0.041), an elevated percentage of neutrophils (OR: 2.85, 95% CI: 1.23–6.59, P = 0.014) and an intra-operative finding of fistula (OR: 3.76, 95% CI: 1.53–9.21, P = 0.004) were significantly associated with the risk for post-operative incisional SSI. CONCLUSIONS: Anemia, elevated percentage of neutrophils and intra-operative finding of fistula are predictors for the development of post-operative incisional SSI in CD patients undergoing bowel resection. Favorable pre-operative nutrition status and low inflammatory status may lessen the incidence of post-operative incisional SSI.
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spelling pubmed-61015092018-08-27 Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection Hu, Tuo Wu, Xianrui Hu, Jiancong Chen, Yufeng Liu, Huashan Zhou, Chi He, Xiaowen Zhi, Min Wu, Xiaojian Lan, Ping Gastroenterol Rep (Oxf) Original Articles BACKGROUND: Patients with Crohn’s disease (CD) are often reported to be at a high risk for incisional surgical site infection (SSI). The aim of this study was to identify the risk factors associated with post-operative incisional SSI in CD patients after bowel resection. METHOD: CD patients undergoing bowel resection between 2007 and 2015 were enrolled. Demographic and clinical features related to post-operative incisional SSI were analysed using both univariate and multivariate logistical analyses. RESULTS: Of all eligible patients (n = 159), 123 (77.4%) were male, with a mean age at surgery of 33.4 ± 11.8 years. A total of 35 (22.0%) CD patients developed post-operative incisional SSI. Post-operative incisional SSI was more likely to happen in patients who had penetrating type of disease (P = 0.018), underwent bowel resection for the indication of chronic fistula (P = 0.005) and had an intra-operative finding of fistula (P = 0.001). A greater proportion of patients with post-operative incisional SSI were found to have anemia (P = 0.019) but elevated levels of white blood cells (P = 0.027), neutrophils (P = 0.006) as well as an elevated percentage of neutrophils (P = 0.005). Multivariate logistic regression analysis showed that anemia (odds ratio [OR]: 3.31, 95% confidence interval [CI]: 1.05–10.46, P = 0.041), an elevated percentage of neutrophils (OR: 2.85, 95% CI: 1.23–6.59, P = 0.014) and an intra-operative finding of fistula (OR: 3.76, 95% CI: 1.53–9.21, P = 0.004) were significantly associated with the risk for post-operative incisional SSI. CONCLUSIONS: Anemia, elevated percentage of neutrophils and intra-operative finding of fistula are predictors for the development of post-operative incisional SSI in CD patients undergoing bowel resection. Favorable pre-operative nutrition status and low inflammatory status may lessen the incidence of post-operative incisional SSI. Oxford University Press 2018-08 2018-04-30 /pmc/articles/PMC6101509/ /pubmed/30151203 http://dx.doi.org/10.1093/gastro/goy007 Text en © The Author(s) 2018. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-Sen University http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Hu, Tuo
Wu, Xianrui
Hu, Jiancong
Chen, Yufeng
Liu, Huashan
Zhou, Chi
He, Xiaowen
Zhi, Min
Wu, Xiaojian
Lan, Ping
Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection
title Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection
title_full Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection
title_fullStr Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection
title_full_unstemmed Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection
title_short Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection
title_sort incidence and risk factors for incisional surgical site infection in patients with crohn’s disease undergoing bowel resection
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101509/
https://www.ncbi.nlm.nih.gov/pubmed/30151203
http://dx.doi.org/10.1093/gastro/goy007
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