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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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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. |
format | Online Article Text |
id | pubmed-6101509 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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