A Gomila1, J Carratalà2, S Biondo3, J M Badia4, D Fraccalvieri5, E Shaw6, V Diaz-Brito7, L Pagespetit8, N Freixas9, M Brugués10, L Mora11, R Perez12, C Sanz13, N Arroyo14, S Iftimie15, E Limón16, F Gudiol16, M Pujol6. 1. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain; VINCat Program, Spain. Electronic address: agomilagrange@gmail.com. 2. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain; VINCat Program, Spain; University of Barcelona, Spain. 3. VINCat Program, Spain; University of Barcelona, Spain; Department of General Surgery, Hospital Universitari de Bellvitge, Spain. 4. VINCat Program, Spain; Department of General Surgery, Hospital General de Granollers, Spain; Universitat Internacional de Catalunya, Spain. 5. VINCat Program, Spain; Department of General Surgery, Hospital Universitari de Bellvitge, Spain. 6. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain; VINCat Program, Spain. 7. VINCat Program, Spain; Department of Infectious Diseases, Parc Sanitari Sant Joan de Déu de Sant Boi, Spain. 8. VINCat Program, Spain; Department of Infectious Diseases, Consorci Sanitari de Terrassa, Spain. 9. VINCat Program, Spain; Department of Infectious Diseases, Hospital Universitari Mútua de Terrassa, Spain. 10. VINCat Program, Spain; Department of Internal Medicine, Consorci Sanitari de l'Anoia, Spain. 11. VINCat Program, Spain; Department of General Surgery, Corporació Sanitària Parc Taulí, Spain. 12. VINCat Program, Spain; Department of Internal Medicine, Fundació Althaia, Spain. 13. VINCat Program, Spain; Department of Internal Medicine, Hospital de Viladecans, Spain. 14. VINCat Program, Spain; Department of General Surgery, Hospital General de Granollers, Spain. 15. VINCat Program, Spain; Department of Internal Medicine, Hospital Universitari Sant Joan de Reus, Spain. 16. VINCat Program, Spain; University of Barcelona, Spain.
Abstract
BACKGROUND: Surgical site infections (SSIs) are the leading cause of healthcare-associated infections in acute care hospitals in Europe. However, the risk factors for the development of early-onset (EO) and late-onset (LO) SSI have not been elucidated. AIM: This study investigated the predictive factors for EO-SSI and LO-SSI in a large cohort of patients undergoing colorectal surgery. METHODS: We prospectively followed-up adult patients undergoing elective colorectal surgery in 10 hospitals (2011-2014). Patients were divided into three groups: EO-SSI, LO-SSI, or no infection (no-SSI). The cut-off defining EO-SSI and LO-SSI was seven days (median time to SSI development). Different predictive factors for EO-SSI and LO-SSI were analysed, comparing each group with the no-SSI patients. FINDINGS: Of 3701 patients, 320 (8.6%) and 349 (9.4%) developed EO-SSI and LO-SSI, respectively. The rest had no-SSI. Patients with EO-SSI were mostly males, had colon surgery and developed organ-space SSI whereas LO-SSI patients frequently received chemotherapy or radiotherapy and had incisional SSI. Male sex (odds ratio (OR): 1.92; P < 0.001), American Society of Anesthesiologists' physical status >2 (OR: 1.51; P = 0.01), administration of mechanical bowel preparation (OR: 0.7; P = 0.03) and stoma creation (OR: 1.95; P < 0.001) predicted EO-SSI whereas rectal surgery (OR: 1.43; P = 0.03), prolonged surgery (OR: 1.4; P = 0.03) and previous chemotherapy (OR: 1.8; P = 0.03) predicted LO-SSI. CONCLUSION: We found distinctive predictive factors for the development of SSI before and after seven days following elective colorectal surgery. These factors could help establish specific preventive measures in each group.
BACKGROUND: Surgical site infections (SSIs) are the leading cause of healthcare-associated infections in acute care hospitals in Europe. However, the risk factors for the development of early-onset (EO) and late-onset (LO) SSI have not been elucidated. AIM: This study investigated the predictive factors for EO-SSI and LO-SSI in a large cohort of patients undergoing colorectal surgery. METHODS: We prospectively followed-up adult patients undergoing elective colorectal surgery in 10 hospitals (2011-2014). Patients were divided into three groups: EO-SSI, LO-SSI, or no infection (no-SSI). The cut-off defining EO-SSI and LO-SSI was seven days (median time to SSI development). Different predictive factors for EO-SSI and LO-SSI were analysed, comparing each group with the no-SSI patients. FINDINGS: Of 3701 patients, 320 (8.6%) and 349 (9.4%) developed EO-SSI and LO-SSI, respectively. The rest had no-SSI. Patients with EO-SSI were mostly males, had colon surgery and developed organ-space SSI whereas LO-SSIpatients frequently received chemotherapy or radiotherapy and had incisional SSI. Male sex (odds ratio (OR): 1.92; P < 0.001), American Society of Anesthesiologists' physical status >2 (OR: 1.51; P = 0.01), administration of mechanical bowel preparation (OR: 0.7; P = 0.03) and stoma creation (OR: 1.95; P < 0.001) predicted EO-SSI whereas rectal surgery (OR: 1.43; P = 0.03), prolonged surgery (OR: 1.4; P = 0.03) and previous chemotherapy (OR: 1.8; P = 0.03) predicted LO-SSI. CONCLUSION: We found distinctive predictive factors for the development of SSI before and after seven days following elective colorectal surgery. These factors could help establish specific preventive measures in each group.
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