OBJECTIVE: The incidence of surgical site infection (SSI) after hysterectomy ranges widely from 2% to 21%. A specific risk stratification index could help to predict more accurately the risk of incisional SSI following abdominal hysterectomy and would help determine the reasons for the wide range of reported SSI rates in individual studies. To increase our understanding of the risk factors needed to build a specific risk stratification index, we performed a retrospective multihospital analysis of risk factors for SSI after abdominal hysterectomy. METHODS: Retrospective case-control study of 545 abdominal and 275 vaginal hysterectomies from July 1, 2003, to June 30, 2005, at 4 institutions. SSIs were defined by using Centers for Disease Control and Prevention/National Nosocomial Infections Surveillance criteria. Independent risk factors for abdominal hysterectomy were identified by using logistic regression. RESULTS: There were 13 deep incisional, 53 superficial incisional, and 18 organ-space SSIs after abdominal hysterectomy and 14 organ-space SSIs after vaginal hysterectomy. Because risk factors for organ-space SSI were different according to univariate analysis, we focused further analyses on incisional SSI after abdominal hysterectomy. The maximum serum glucose level within 5 days after operation was highest in patients with deep incisional SSI, lower in patients with superficial incisional SSI, and lowest in uninfected patients (median, 189, 156, and 141 mg/dL, respectively; P = .005). Independent risk factors for incisional SSI included blood transfusion (odds ratio [OR], 2.4) and morbid obesity (body mass index [BMI], >35; OR, 5.7). Duration of operation greater than the 75th percentile (OR, 1.7), obesity (BMI, 30-35; OR, 3.0), and lack of private health insurance (OR, 1.7) were marginally associated with increased odds of SSI. CONCLUSIONS: Incisional SSI after abdominal hysterectomy was associated with increased BMI and blood transfusion. Longer duration of operation and lack of private health insurance were marginally associated with SSI.
OBJECTIVE: The incidence of surgical site infection (SSI) after hysterectomy ranges widely from 2% to 21%. A specific risk stratification index could help to predict more accurately the risk of incisional SSI following abdominal hysterectomy and would help determine the reasons for the wide range of reported SSI rates in individual studies. To increase our understanding of the risk factors needed to build a specific risk stratification index, we performed a retrospective multihospital analysis of risk factors for SSI after abdominal hysterectomy. METHODS: Retrospective case-control study of 545 abdominal and 275 vaginal hysterectomies from July 1, 2003, to June 30, 2005, at 4 institutions. SSIs were defined by using Centers for Disease Control and Prevention/National Nosocomial Infections Surveillance criteria. Independent risk factors for abdominal hysterectomy were identified by using logistic regression. RESULTS: There were 13 deep incisional, 53 superficial incisional, and 18 organ-space SSIs after abdominal hysterectomy and 14 organ-space SSIs after vaginal hysterectomy. Because risk factors for organ-space SSI were different according to univariate analysis, we focused further analyses on incisional SSI after abdominal hysterectomy. The maximum serum glucose level within 5 days after operation was highest in patients with deep incisional SSI, lower in patients with superficial incisional SSI, and lowest in uninfected patients (median, 189, 156, and 141 mg/dL, respectively; P = .005). Independent risk factors for incisional SSI included blood transfusion (odds ratio [OR], 2.4) and morbid obesity (body mass index [BMI], >35; OR, 5.7). Duration of operation greater than the 75th percentile (OR, 1.7), obesity (BMI, 30-35; OR, 3.0), and lack of private health insurance (OR, 1.7) were marginally associated with increased odds of SSI. CONCLUSIONS: Incisional SSI after abdominal hysterectomy was associated with increased BMI and blood transfusion. Longer duration of operation and lack of private health insurance were marginally associated with SSI.
Authors: Margaret A Olsen; Patricia Lock-Buckley; Diane Hopkins; Louis B Polish; Thoralf M Sundt; Victoria J Fraser Journal: J Thorac Cardiovasc Surg Date: 2002-07 Impact factor: 5.209
Authors: Ahmed N Al-Niaimi; Mostafa Ahmed; Nikki Burish; Saygin A Chackmakchy; Songwon Seo; Stephen Rose; Ellen Hartenbach; David M Kushner; Nasia Safdar; Laurel Rice; Joseph Connor Journal: Gynecol Oncol Date: 2014-09-28 Impact factor: 5.482
Authors: Anthony D Harris; Lisa Pineles; Deverick Anderson; Keith F Woeltje; William E Trick; Keith S Kaye; Deborah S Yokoe; Ann-Christine Nyquist; David P Calfee; Surbhi Leekha Journal: Infect Control Hosp Epidemiol Date: 2016-12-29 Impact factor: 3.254
Authors: Christopher S Pepin; Kerri A Thom; John D Sorkin; Surbhi Leekha; Max Masnick; Michael Anne Preas; Lisa Pineles; Anthony D Harris Journal: Infect Control Hosp Epidemiol Date: 2015-04 Impact factor: 3.254
Authors: J Brian Szender; Peter J Frederick; Kevin H Eng; Stacey N Akers; Shashikant B Lele; Kunle Odunsi Journal: Int J Gynecol Cancer Date: 2015-03 Impact factor: 3.437
Authors: Mike K Liang; Christopher J Goodenough; Robert G Martindale; J Scott Roth; Lillian S Kao Journal: Surg Infect (Larchmt) Date: 2015-02 Impact factor: 2.150
Authors: Amira A Bhalodi; Pavlos K Papasavas; Darren S Tishler; David P Nicolau; Joseph L Kuti Journal: Antimicrob Agents Chemother Date: 2012-12-17 Impact factor: 5.191
Authors: AeuMuro Gashaw Lake; Alexandra M McPencow; Madeline A Dick-Biascoechea; Deanna K Martin; Elisabeth A Erekson Journal: Am J Obstet Gynecol Date: 2013-06-13 Impact factor: 8.661
Authors: Shitanshu Uppal; John Harris; Ahmed Al-Niaimi; Carolyn W Swenson; Mark D Pearlman; R Kevin Reynolds; Neil Kamdar; Ali Bazzi; Darrell A Campbell; Daniel M Morgan Journal: Obstet Gynecol Date: 2016-02 Impact factor: 7.661