Edin Mujagic1, Walter R Marti2, Michael Coslovsky3, Jasmin Zeindler4, Sebastian Staubli5, Regula Marti6, Robert Mechera7, Savas D Soysal8, Lorenz Gürke9, Walter P Weber10. 1. Department of Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. Electronic address: edin.mujagic@usb.ch. 2. Department of Surgery, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland. Electronic address: martiwr@bluewin.ch. 3. University of Basel, University Hospital, Department of Clinical Research, Clinical Trial Unit, Spitalstrasse 12, 4031, Basel, Switzerland. Electronic address: michael.coslovsky@usb.ch. 4. Department of Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. Electronic address: jasmin.zeindler@usb.ch. 5. Department of Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. Electronic address: sebastian.staubli@usb.ch. 6. Department of Surgery, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland. Electronic address: regula.marti@ksa.ch. 7. Department of Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. Electronic address: robert.mechera@usb.ch. 8. Department of Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. Electronic address: savas.soysal@usb.ch. 9. Department of Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. Electronic address: lorenz.guerke@usb.ch. 10. Department of Surgery, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. Electronic address: walter.weber@usb.ch.
Abstract
BACKGROUND: Routine preoperative blood work is not recommended but selected biochemical markers may predict the risk of surgical site infection (SSI). This study examines the association between preoperative biochemical markers and the risk of SSI. METHODS: This observational cohort study, nested in a randomized controlled trial, was conducted at two tertiary referral centers in Switzerland. RESULTS: 122 (5.8%) of 2093 patients experienced SSI. Preoperative increasing levels of albumin (OR 0.93), CRP (OR 1.34), hemoglobin (OR 0.87) and eGFR (OR 0.90) were significantly associated with the odds of SSI. The same accounts for categorized parameters. The highest area under the curve from ROC curves was 0.62 for albumin. Positive predictive values ranged from 6.4% to 9.5% and negative predictive values from 94.8% to 95.7%. The association of CRP, mildly and moderately decreased eGFR and hemoglobin with the odds of SSI remained significant on multivariate analysis. CONCLUSIONS: Our results do not support generally delaying elective surgery based on preoperative blood results. However, it may be considered in situations with potentially severe sequelae of SSI.
RCT Entities:
BACKGROUND: Routine preoperative blood work is not recommended but selected biochemical markers may predict the risk of surgical site infection (SSI). This study examines the association between preoperative biochemical markers and the risk of SSI. METHODS: This observational cohort study, nested in a randomized controlled trial, was conducted at two tertiary referral centers in Switzerland. RESULTS: 122 (5.8%) of 2093 patients experienced SSI. Preoperative increasing levels of albumin (OR 0.93), CRP (OR 1.34), hemoglobin (OR 0.87) and eGFR (OR 0.90) were significantly associated with the odds of SSI. The same accounts for categorized parameters. The highest area under the curve from ROC curves was 0.62 for albumin. Positive predictive values ranged from 6.4% to 9.5% and negative predictive values from 94.8% to 95.7%. The association of CRP, mildly and moderately decreased eGFR and hemoglobin with the odds of SSI remained significant on multivariate analysis. CONCLUSIONS: Our results do not support generally delaying elective surgery based on preoperative blood results. However, it may be considered in situations with potentially severe sequelae of SSI.
Authors: Michael D Dubé; Christopher A Rothfusz; Ahmed K Emara; Matthew Hadad; Peter Surace; Viktor E Krebs; Robert M Molloy; Nicolas S Piuzzi Journal: Curr Rev Musculoskelet Med Date: 2022-05-03
Authors: Maria Abuhadi; Reema Alghoribi; Lama A Alharbi; Zahrah Barnawi; Raghad AlQulayti; Arwa Ahmed; Maha Al-Alawi; Saleh S Baeesa Journal: Cureus Date: 2022-07-30