H Fukuda1. 1. Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: h_fukuda@hcam.med.kyushu-u.ac.jp.
Abstract
OBJECTIVE: To identify patient-related risk factors for surgical site infection (SSI) following eight types of gastrointestinal surgery that could be collected as part of infection surveillance efforts. DESIGN: Record linkage from existing datasets comprising the Japan Nosocomial Infections Surveillance (JANIS) and Diagnosis Procedure Combination (DPC) programmes. METHODS: Patient data from 35 hospitals were retrieved using JANIS and DPC from 2007 to 2011. Patient-related factors and the incidence of SSI were recorded and analysed. Risk factors associated with SSI were examined using multi-level mixed-effects logistic regression models. RESULTS: In total, 2074 appendectomies; 2084 bile duct, liver or pancreatic procedures; 3460 cholecystectomies; 7273 colonic procedures; 482 oesophageal procedures; 4748 gastric procedures; 2762 rectal procedures and 1202 small bowel procedures were analysed. Using multi-variate analyses, intra-operative blood transfusion was found to be a risk factor for SSI following all types of gastrointestinal surgery, except appendectomy and small bowel surgery. In addition, diabetes was found to be a risk factor for SSI following colon surgery [odds ratio (OR) 1.23, P=0.028] and gastric surgery (OR 1.70, P<0.001). Use of steroids was significantly associated with a higher incidence of SSI following cholecystectomy (OR 2.83, P=0.003) and colon surgery (OR 1.27, P=0.040). CONCLUSIONS: Intra-operative blood transfusion, diabetes and use of steroids are risk factors for SSI following gastrointestinal surgery, and should be included as part of SSI surveillance for these procedures.
OBJECTIVE: To identify patient-related risk factors for surgical site infection (SSI) following eight types of gastrointestinal surgery that could be collected as part of infection surveillance efforts. DESIGN: Record linkage from existing datasets comprising the Japan Nosocomial Infections Surveillance (JANIS) and Diagnosis Procedure Combination (DPC) programmes. METHODS:Patient data from 35 hospitals were retrieved using JANIS and DPC from 2007 to 2011. Patient-related factors and the incidence of SSI were recorded and analysed. Risk factors associated with SSI were examined using multi-level mixed-effects logistic regression models. RESULTS: In total, 2074 appendectomies; 2084 bile duct, liver or pancreatic procedures; 3460 cholecystectomies; 7273 colonic procedures; 482 oesophageal procedures; 4748 gastric procedures; 2762 rectal procedures and 1202 small bowel procedures were analysed. Using multi-variate analyses, intra-operative blood transfusion was found to be a risk factor for SSI following all types of gastrointestinal surgery, except appendectomy and small bowel surgery. In addition, diabetes was found to be a risk factor for SSI following colon surgery [odds ratio (OR) 1.23, P=0.028] and gastric surgery (OR 1.70, P<0.001). Use of steroids was significantly associated with a higher incidence of SSI following cholecystectomy (OR 2.83, P=0.003) and colon surgery (OR 1.27, P=0.040). CONCLUSIONS: Intra-operative blood transfusion, diabetes and use of steroids are risk factors for SSI following gastrointestinal surgery, and should be included as part of SSI surveillance for these procedures.
Authors: J M van Niekerk; M C Vos; A Stein; L M A Braakman-Jansen; A F Voor In 't Holt; J E W C van Gemert-Pijnen Journal: PLoS One Date: 2020-10-28 Impact factor: 3.240