Surgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery

doi:10.1016/j.ajic.2007.12.011

American Journal of Infection Control

Volume 36, Issue 10, December 2008, Pages 727-731

https://doi.org/10.1016/j.ajic.2007.12.011 Get rights and content

Background

Surgical site infection (SSI) is an important clinical indicator of quality of patient care and infection control; therefore, we aimed to assess risk factors SSI in colon and gastric surgeries.

Methods

SSI was assessed according to the National Nosocomial Infection Surveillance (NNIS) system (1999). Risk factors examined included operative approach, operative procedure, duration of operation, diabetes mellitus (DM), body mass index (BMI), age, and sex.

Results

Among 3152 operated patients, 1675 patients were included in the study. The univariate analysis showed that male sex, high BMI, and long duration of operation were significant risk factors for colon surgery and that advanced age, presence of DM and long duration of operation were significant risk factors for gastric surgery. The multivariate analysis indicated that significant risk factors for SSI were BMI of 25 or above, open surgery, and long duration of operation for colon surgery and open surgery for gastric surgery. The SSI rate of laparoscopic colon surgery was 40%, less than that of open colon surgery, and that of laparoscopic gastric surgery was 75%, less than that of open gastric surgery.

Conclusion

The risk factors for SSI depend on whether the operation is laparoscopic or open and duration of operation. In addition, BMI (25 or above) and age (70 years or above) are risk factors for colon and gastric surgery, respectively.

Section snippets

Patients

From August 1997 to December 2005, 3152 cancer patients underwent colon or gastric surgery under general anesthesia at our hospital. For the statistical analysis, 1675 patients (colon cancer: 801, gastric cancer: 874) who underwent sigmoidectomy, hemicolectomy, low anterior resection, or transverse colon surgery for colon cancer or local gastrectomy or pyloric gastrectomy for gastric cancer were enrolled. The remaining 1477 patients were excluded because the numbers of patients with other

Results

There were 1747 colon surgeries and 1405 gastric surgeries performed as inpatient procedures. The percentages of colon and gastric procedures performed laparoscopically were 37.5% (655/1747) and 12.0% (169/1405), respectively.

The overall SSI rates were 19.7% (129/655) for laparoscopic colon surgeries, 24.5% (267/1092) for open colon surgeries, 4.7% (8/169) for laparoscopic gastric surgeries, and 12.1% (150/1236) for open gastric surgeries (Table 1). For the statistical analysis, 1675 patients

Discussion

SSI rates with laparoscopic surgery were lower than that of open surgery in colon cases by 40% and in gastric cases by 60%. These results are the most important findings reported in this paper. The multivariate analysis identified the operative procedure (laparoscopic vs open surgery) as a risk factor for SSI, and laparoscopic surgery was associated with a significantly lower risk of SSI.

SSI after colon surgery (laparoscopic, 19.7%; open, 24.5%) was considerably higher in this study compared

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: Conflicts of interest: All authors report no conflicts of interest.

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Major articleSurgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery

Background

Methods

Results

Conclusion

Section snippets

Patients

Results

Discussion

J Infect Chemother

J Hosp Infect

J Hosp Infect

Surgical site infection surveillance—SSI after general-gastrointestinal surgery and cardiac surgery

J Jpn Environ Infect Control

Does using a laparoscopic approach to cholecystectomy decrease the risk of surgical site infection?

Ann Surg

Surgical surveillance component, p.XI 1-10 XII 25,30 XIII 11-13 In: National Nosocomial Infections Surveillance (NNIS) System manual. U.S. Department of Health and Human Services

Major article
Surgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery