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1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy
BACKGROUND: Exploratory laparotomy surgery is abdominal operations not involving the gastrointestinal tract or biliary system. The objective of our study is to answer three questions: (a) What is the risk of surgical site infection (SSI) after exploratory abdominal surgery? (b) What is the impact of...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809379/ http://dx.doi.org/10.1093/ofid/ofz360.1110 |
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author | Rodrigues, Túlio Alves Jeangregório Fernandes de Oliveira, Guilherme Dias, Júlia G C Campos, Laís Souza Rodrigues, Letícia Correa, Paulo Roberto Alvim Soier, Rute Rodrigues Starling, Carlos E F Couto, Bráulio R G M |
author_facet | Rodrigues, Túlio Alves Jeangregório Fernandes de Oliveira, Guilherme Dias, Júlia G C Campos, Laís Souza Rodrigues, Letícia Correa, Paulo Roberto Alvim Soier, Rute Rodrigues Starling, Carlos E F Couto, Bráulio R G M |
author_sort | Rodrigues, Túlio Alves Jeangregório |
collection | PubMed |
description | BACKGROUND: Exploratory laparotomy surgery is abdominal operations not involving the gastrointestinal tract or biliary system. The objective of our study is to answer three questions: (a) What is the risk of surgical site infection (SSI) after exploratory abdominal surgery? (b) What is the impact of SSI in the hospital length of stay and hospital mortality? (c) What are risk factors for SSI after exploratory abdominal surgery? METHODS: A retrospective cohort study assessed meningitis and risk factors in patients undergoing exploratory laparotomy between January 2013 and December 2017 from 12 hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the National Healthcare Safety Network (NHSN)/CDC procedure-associated protocols for routine SSI surveillance. 26 preoperative and operative categorical and continuous variables were evaluated by univariate and multivariate analysis (logistic regression). Outcome variables: Surgical site infection (SSI), hospital death, hospital length of stay. Variables were analyzed using Epi Info and applying statistical two-tailed test hypothesis with significance level of 5%. RESULTS: A sample of 6,591 patients submitted to exploratory laparotomy was analyzed (SSI risk = 4.3%): Hospital length of stay in noninfected patients (days): mean = 16, median = 6, std. dev. = 30; hospital stay in infected patients: mean = 32, median = 22, std. dev. = 30 (P < 0.001). The mortality rate in patients without infection was 14% while hospital death of infected patients was 20% (P = 0.009). Main risk factors for SSI: ügeneral anesthesia (SSI = 4.9%, relative risk – RR = 2.8, P < 0.001); preoperative hospital length of stay more than 4 days (SSI=3.9%, RR=1.8, P = 0.003); wound class contaminated or dirty (SSI = 5.4%, RR = 1.5, P = 0.002); duration of procedure higher than 3 hours (SSI = 7.1%, RR = 2.1, P < 0.001); after trauma laparotomy (SSI = 7.8%, RR = 1.9, P = 0.001). CONCLUSION: We identified patients at high risk of surgical site infection after exploratory laparotomy: trauma patients from contaminated or dirty wound surgery, submitted to a procedure with general anesthesia that last more than 3 hours have 13% SSI. Patients without any of these four risk factors have only 1.2% SSI. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6809379 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68093792019-10-28 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy Rodrigues, Túlio Alves Jeangregório Fernandes de Oliveira, Guilherme Dias, Júlia G C Campos, Laís Souza Rodrigues, Letícia Correa, Paulo Roberto Alvim Soier, Rute Rodrigues Starling, Carlos E F Couto, Bráulio R G M Open Forum Infect Dis Abstracts BACKGROUND: Exploratory laparotomy surgery is abdominal operations not involving the gastrointestinal tract or biliary system. The objective of our study is to answer three questions: (a) What is the risk of surgical site infection (SSI) after exploratory abdominal surgery? (b) What is the impact of SSI in the hospital length of stay and hospital mortality? (c) What are risk factors for SSI after exploratory abdominal surgery? METHODS: A retrospective cohort study assessed meningitis and risk factors in patients undergoing exploratory laparotomy between January 2013 and December 2017 from 12 hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the National Healthcare Safety Network (NHSN)/CDC procedure-associated protocols for routine SSI surveillance. 26 preoperative and operative categorical and continuous variables were evaluated by univariate and multivariate analysis (logistic regression). Outcome variables: Surgical site infection (SSI), hospital death, hospital length of stay. Variables were analyzed using Epi Info and applying statistical two-tailed test hypothesis with significance level of 5%. RESULTS: A sample of 6,591 patients submitted to exploratory laparotomy was analyzed (SSI risk = 4.3%): Hospital length of stay in noninfected patients (days): mean = 16, median = 6, std. dev. = 30; hospital stay in infected patients: mean = 32, median = 22, std. dev. = 30 (P < 0.001). The mortality rate in patients without infection was 14% while hospital death of infected patients was 20% (P = 0.009). Main risk factors for SSI: ügeneral anesthesia (SSI = 4.9%, relative risk – RR = 2.8, P < 0.001); preoperative hospital length of stay more than 4 days (SSI=3.9%, RR=1.8, P = 0.003); wound class contaminated or dirty (SSI = 5.4%, RR = 1.5, P = 0.002); duration of procedure higher than 3 hours (SSI = 7.1%, RR = 2.1, P < 0.001); after trauma laparotomy (SSI = 7.8%, RR = 1.9, P = 0.001). CONCLUSION: We identified patients at high risk of surgical site infection after exploratory laparotomy: trauma patients from contaminated or dirty wound surgery, submitted to a procedure with general anesthesia that last more than 3 hours have 13% SSI. Patients without any of these four risk factors have only 1.2% SSI. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809379/ http://dx.doi.org/10.1093/ofid/ofz360.1110 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Rodrigues, Túlio Alves Jeangregório Fernandes de Oliveira, Guilherme Dias, Júlia G C Campos, Laís Souza Rodrigues, Letícia Correa, Paulo Roberto Alvim Soier, Rute Rodrigues Starling, Carlos E F Couto, Bráulio R G M 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy |
title | 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy |
title_full | 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy |
title_fullStr | 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy |
title_full_unstemmed | 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy |
title_short | 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy |
title_sort | 1247. multicenter study on risk factors for surgical site infection after exploratory laparotomy |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809379/ http://dx.doi.org/10.1093/ofid/ofz360.1110 |
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