| Literature DB >> 29553001 |
Mini Kamboj1, Teresa Childers1, Jessica Sugalski2, Donna Antonelli3, Juliane Bingener-Casey4, Jamie Cannon5, Karie Cluff6, Kimberly A Davis7, E Patchen Dellinger8, Sean C Dowdy9, Kim Duncan10, Julie Fedderson10, Robert Glasgow11, Bruce Hall12, Marilyn Hirsch13, Matthew Hutter14, Lisa Kimbro2, Boris Kuvshinoff15, Martin Makary16, Melanie Morris5, Sharon Nehring17, Sonia Ramamoorthy18, Rebekah Scott18, Mindy Sovel19, Vivian Strong19, Ashley Webster20, Elizabeth Wick16, Julio Garcia Aguilar19, Robert Carlson2, Kent Sepkowitz1.
Abstract
BACKGROUNDSurgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.OBJECTIVETo examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRSDESIGNAmerican College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.SETTINGMulticenter studyPARTICIPANTSOf 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.MAIN OUTCOMEThe primary outcome of interest was 30-day SSI rate.RESULTSA total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23-2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09-1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06-2.53; P=.02), and longer duration of procedure were associated with development of SSI.CONCLUSIONSPatients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes.Infect Control Hosp Epidemiol 2018;39:555-562.Entities:
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Year: 2018 PMID： 29553001 PMCID： PMC6707075 DOI： 10.1017/ice.2018.40
Source DB: PubMed Journal: Infect Control Hosp Epidemiol ISSN： 0899-823X Impact factor: 3.254