Fernando M Biscione1, Renato C Couto, Tânia M Pedrosa, Mozar C Neto. 1. Health Sciences Postgraduate Course, Medicine High School, Minas Gerais Federal University, 190 Alfredo Balena Avenue, Room 7003, Santa Efigênia, Belo Horizonte, Minas Gerais 31.130-100, Brazil. fernandobiscione@yahoo.com.ar
Abstract
OBJECTIVES: We assessed the contribution of the surgical approach and the NNIS system's surgical component variables to surgical site infection (SSI) risk after diagnostic exploration of the abdominal cavity. METHODS: Retrospective cohort study with prospective data collection (1993-2006) in five private, non-universitary, secondary or tertiary healthcare facilities. Outcome variable was SSI development within 30 days after surgery. Explanatory variables were age, gender, surgical approach (laparoscopic/open), elective/emergency/trauma procedure, hospital, surgeon, year, additional procedures, wound class, operation duration and ASA-PS score. RESULTS: Consecutive in-patients (6761) were included. Mean age was 38.1 (+/-14.1) years and 87.3% were female; 68% procedures were laparoscopic. Postdischarge follow-up was obtained for 57.7% patients. Patients operated on laparoscopically had reduced adjusted overall risk of SSI (OR=0.40, 95% CI=0.28-0.56), incisional infection (OR=0.43, 95% CI=0.29-0.62) and organ/space infection (OR=0.19, 95% CI=0.07-0.49). Older age, longer procedures, emergency or trauma procedures, medium- or high-risk surgeons and year <or=1999 increased the adjusted risk of incisional infection. Adjusted risk of organ/space infection was higher in older patients, emergency or trauma procedures, additional procedures and procedures performed by high-risk surgeons. CONCLUSIONS: Laparoscopy was associated with lower risk of incisional and organ/space infection. NNIS system's surgical component variables contributed variably to SSI risk.
OBJECTIVES: We assessed the contribution of the surgical approach and the NNIS system's surgical component variables to surgical site infection (SSI) risk after diagnostic exploration of the abdominal cavity. METHODS: Retrospective cohort study with prospective data collection (1993-2006) in five private, non-universitary, secondary or tertiary healthcare facilities. Outcome variable was SSI development within 30 days after surgery. Explanatory variables were age, gender, surgical approach (laparoscopic/open), elective/emergency/trauma procedure, hospital, surgeon, year, additional procedures, wound class, operation duration and ASA-PS score. RESULTS: Consecutive in-patients (6761) were included. Mean age was 38.1 (+/-14.1) years and 87.3% were female; 68% procedures were laparoscopic. Postdischarge follow-up was obtained for 57.7% patients. Patients operated on laparoscopically had reduced adjusted overall risk of SSI (OR=0.40, 95% CI=0.28-0.56), incisional infection (OR=0.43, 95% CI=0.29-0.62) and organ/space infection (OR=0.19, 95% CI=0.07-0.49). Older age, longer procedures, emergency or trauma procedures, medium- or high-risk surgeons and year <or=1999 increased the adjusted risk of incisional infection. Adjusted risk of organ/space infection was higher in older patients, emergency or trauma procedures, additional procedures and procedures performed by high-risk surgeons. CONCLUSIONS: Laparoscopy was associated with lower risk of incisional and organ/space infection. NNIS system's surgical component variables contributed variably to SSI risk.
Authors: Elissa K Butler; Brianna M Mills; Saman Arbabi; Jonathan I Groner; Monica S Vavilala; Frederick P Rivara Journal: J Surg Res Date: 2020-03-19 Impact factor: 2.192
Authors: Hang Cheng; Brian Po-Han Chen; Ireena M Soleas; Nicole C Ferko; Chris G Cameron; Piet Hinoul Journal: Surg Infect (Larchmt) Date: 2017 Aug/Sep Impact factor: 2.150