Aina Gomila1, Josep Ma Badia2, Jordi Carratalà3, Xavier Serra-Aracil4, Evelyn Shaw5, Vicens Diaz-Brito6, Antoni Castro7, Elena Espejo8, Carmen Nicolás9, Marta Piriz10, Montserrat Brugués11, Josefina Obradors12, Ana Lérida13, Jordi Cuquet14, Enric Limón15, Francesc Gudiol16, Miquel Pujol17. 1. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; VINCat Program, Spain. Electronic address: agomilagrange@gmail.com. 2. Department of General Surgery, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain; VINCat Program, Spain. Electronic address: jmbadia@fhag.es. 3. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; VINCat Program, Spain; University of Barcelona, Barcelona, Spain. Electronic address: jcarratala@bellvitgehospital.cat. 4. Department of Surgery and Infection Control Team, Corporació Sanitària Parc Taulí, Barcelona, Spain; VINCat Program, Spain. Electronic address: jserraa@tauli.cat. 5. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; VINCat Program, Spain. Electronic address: eshawp@gmail.com. 6. Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu de Sant Boi, Barcelona, Spain. Electronic address: vicente.diaz@pssjd.org. 7. Department of Internal Medicine, Hospital Universitari Sant Joan de Reus, Tarragona, Spain; VINCat Program, Spain. Electronic address: antoni.castro@urv.cat. 8. Department of Infectious Diseases, Consorci Sanitari de Terrassa, Barcelona, Spain; VINCat Program, Spain. Electronic address: 12088eea@comb.cat. 9. Department of Infectious Diseases, Hospital Universitari Mútua de Terrassa, Barcelona, Spain; VINCat Program, Spain. Electronic address: mcnicolas@mutuaterrassa.cat. 10. Department of Surgery and Infection Control Team, Corporació Sanitària Parc Taulí, Barcelona, Spain; VINCat Program, Spain. Electronic address: mpiriz@tauli.cat. 11. Department of Internal Medicine, Consorci Sanitari de l'Anoia, Barcelona, Spain; VINCat Program, Spain. Electronic address: mbrugues@csa.cat. 12. Department of Internal Medicine, Fundació Althaia, Barcelona, Spain; VINCat Program, Spain. Electronic address: jobradors@althaia.cat. 13. Department of Internal Medicine, Hospital de Viladecans, Barcelona, Spain; VINCat Program, Spain. Electronic address: alerida@gencat.cat. 14. Department of General Surgery, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain; VINCat Program, Spain. Electronic address: jcuquet@fhag.es. 15. VINCat Program, Spain. Electronic address: elimon@bellvitgehospital.cat. 16. VINCat Program, Spain; University of Barcelona, Barcelona, Spain. Electronic address: fgudiol@bellvitgehospital.cat. 17. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Barcelona, Spain; VINCat Program, Spain. Electronic address: mpujol@bellvitgehospital.cat.
Abstract
OBJECTIVE: To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery. METHODS: A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery. RESULTS: Of 3701 patients, 669 (18.1%) developed SSI; 336 (9.1%) were organ-space infections. Among patients with organ-space SSI, 81.2% required source control: 60.4% reoperation and 20.8% percutaneous/transrectal drainage. Overall treatment failure rate was 21.7%: 9% in incisional SSIs and 34.2% in organ-space SSIs (p < 0.001). Median length of stay was 15 days (IQR 9-22) for incisional SSIs and 24 days (IQR 17-35) for organ-space SSIs (p < 0.001). One hundred and twenty-seven patients (19%) required readmission and 35 patients died (5.2%). Risk factors for treatment failure among patients with organ-space SSI were age ≥65 years (OR 1.83, 95% CI: 1.07-1.83), laparoscopy (OR 1.7, 95% CI: 1.06-2.77), and reoperation (OR 2.8, 95% CI: 1.7-4.6). CONCLUSIONS: Rates of SSI and treatment failure in organ-space SSI after elective colorectal surgery are notably high. Careful attention should be paid to older patients with previous laparoscopy requiring reoperation for organ-space SSI, so that treatment failure can be identified early.
OBJECTIVE: To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery. METHODS: A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery. RESULTS: Of 3701 patients, 669 (18.1%) developed SSI; 336 (9.1%) were organ-space infections. Among patients with organ-space SSI, 81.2% required source control: 60.4% reoperation and 20.8% percutaneous/transrectal drainage. Overall treatment failure rate was 21.7%: 9% in incisional SSIs and 34.2% in organ-space SSIs (p < 0.001). Median length of stay was 15 days (IQR 9-22) for incisional SSIs and 24 days (IQR 17-35) for organ-space SSIs (p < 0.001). One hundred and twenty-seven patients (19%) required readmission and 35 patients died (5.2%). Risk factors for treatment failure among patients with organ-space SSI were age ≥65 years (OR 1.83, 95% CI: 1.07-1.83), laparoscopy (OR 1.7, 95% CI: 1.06-2.77), and reoperation (OR 2.8, 95% CI: 1.7-4.6). CONCLUSIONS: Rates of SSI and treatment failure in organ-space SSI after elective colorectal surgery are notably high. Careful attention should be paid to older patients with previous laparoscopy requiring reoperation for organ-space SSI, so that treatment failure can be identified early.
Authors: K T Park; L Sceats; M Dehghan; A W Trickey; A Wren; J J Wong; R Bensen; B N Limketkai; K Keyashian; C Kin Journal: Aliment Pharmacol Ther Date: 2018-06-07 Impact factor: 8.171
Authors: A Gomila; J Carratalà; J M Badia; D Camprubí; M Piriz; E Shaw; V Diaz-Brito; E Espejo; C Nicolás; M Brugués; R Perez; A Lérida; A Castro; S Biondo; D Fraccalvieri; E Limón; F Gudiol; M Pujol Journal: BMC Infect Dis Date: 2018-10-05 Impact factor: 3.090
Authors: Brenig Llwyd Gwilym; Athanasios Saratzis; Ruth Benson; Rachael Forsythe; George Dovell; Nikesh Dattani; Tristan Lane; Ryan Preece; Joseph Shalhoub; David Charles Bosanquet Journal: Int J Surg Protoc Date: 2019-07-26