Epidemiology and risk factors associated with surgical site infection following surgery on thoracic aorta

AbstractSurgical site infection (SSI) following cardiovascular surgery has been well documented, possibly owing to its highly invasive nature, but SSI following surgery on the thoracic aorta has not. This study aimed to describe the epidemiology and assess risk factors associated with the latter in Japan using a national database for SSI. Data on surgery on thoracic aorta performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance (JANIS) database. Risk factors were assessed initially by univariate analysis, and then entered into a logistic regression model for final evaluation. The cumulative incidence of SSI was 4.1% (146/3538) and staphylococci were the most frequent pathogens isolated. Factors such as the duration of operation, emergency surgery and male gender were significantly associated with SSI. These findings differ from previous studies on open heart and coronary artery bypass surgery, in which the American Society of Anesthesiologists (ASA) score was significantly associated with SSI, but gender was not. This study suggests that risk stratification in the JANIS system might be improved by incorporating additionally identified factors for risk adjustment, when comparing the incidence of SSI between hospitals.

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Risk Factors Associated With Surgical Site Infection After Pediatric Posterior Spinal Fusion Procedure

Infection Control and Hospital Epidemiology ◽

10.1086/593952 ◽

2009 ◽

Vol 30 (2) ◽

pp. 109-116 ◽

Cited By ~ 85

Author(s):

W. Matthew Linam ◽

Peter A. Margolis ◽

Mary Allen Staat ◽

Maria T. Britto ◽

Richard Hornung ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Antibiotic Prophylaxis ◽

Spinal Fusion ◽

Univariate Analysis ◽

Posterior Spinal Fusion ◽

Site Infection ◽

Fusion Procedure ◽

Factors Associated ◽

Asa Score

Objective.To identify risk factors associated with surgical site infection (SSI) after pediatric posterior spinal fusion procedure by examining characteristics related to the patient, the surgical procedure, and tissue hypoxia.Design.Retrospective case-control study nested in a hospital cohort study.Setting.A 475-bed, tertiary care children's hospital.Methods.All patients who underwent a spinal fusion procedure during the period from January 1995 through December 2006 were included. SSI cases were identified by means of prospective surveillance using National Nosocomial Infection Surveillance system definitions. Forty-four case patients who underwent a posterior spinal fusion procedure and developed an SSI were identified and evaluated. Each case patient was matched (on the basis of date of surgery, ± 3 months) to 3 control patients who underwent a posterior spinal fusion procedure but did not develop an SSI. Risk factors for SSI were evaluated by univariate analysis and multivariable conditional logistic regression. Odds ratios (ORs), with 95% confidence intervals (CIs) andPvalues, were calculated.Results.From 1995 to 2006, the mean annual rate of SSI after posterior spinal fusion procedure was 4.4% (range, 1.1%—6.7%). Significant risk factors associated with SSI in the univariate analysis included the following: a body mass index (BMI) greater than the 95th percentile (OR, 3.5 [95% CI, 1.5–8.3]); antibiotic prophylaxis with clindamycin, compared with other antibiotics (OR, 3.5 [95% CI, 1.2 10.0]); inappropriately low dose of antibiotic (OR, 2.6 [95% CI, 1.0–6.6]); and a longer duration of hypothermia (ie, a core body temperature of less than 35.5°C) during surgery (OR, 0.4 [95% CI, 0.2–0.9]). An American Society of Anesthesiologists (ASA) score of greater than 2, obesity (ie, a BMI greater than the 95th percentile), antibiotic prophylaxis with clindamycin, and hypothermia were statistically significant in the multivariable model.Conclusion.An ASA score greater than 2, obesity, and antibiotic prophylaxis with clindamycin were independent risk factors for SSI. Hypothermia during surgery appears to provide protection against SSI in this patient population.

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Factors Associated With Surgical Site Infection Following Gastric Surgery in Japan

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2016.155 ◽

2016 ◽

Vol 37 (10) ◽

pp. 1167-1172 ◽

Cited By ~ 5

Author(s):

Keita Morikane ◽

Hitoshi Honda ◽

Satowa Suzuki

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Emergency Operation ◽

Hospital Performance ◽

Gastric Surgery ◽

National Database ◽

Site Infection ◽

Healthcare Facilities ◽

Factors Associated ◽

Healthcare Associated

BACKGROUNDSurgical site infection (SSI) following gastric surgery has not been well documented.OBJECTIVETo describe and assess factors associated with SSI following gastric surgery in Japan using a Japanese national database for healthcare-associated infections.DESIGNA retrospective nationwide surveillance-based study.SETTINGJapanese healthcare facilities.METHODSData on gastric surgeries performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance. Gastric surgery was divided into 3 types of procedures: total gastrectomy (GAST-T), distal gastrectomy (GAST-D), and other types of gastric surgery (GAST-O). The incidence of and factors associated with SSI following gastric surgery were assessed by the 3 types of procedures.RESULTSThe cumulative incidence of SSI following gastric surgery was 8.8% (3,156/36,052). The incidence of SSI following GAST-T (12.4%) was significantly higher than that following GAST-D (7.01%) or GAST-O (7.84%). Besides the 4 conventional risk factors for predicting SSI, additional risk factors were identified. Male sex was significantly associated with SSI following all types of gastric surgery, but the effect of the association was substantially different (adjusted odds ratio, 1.52, 1.47, and 1.28 for GAST-T, GAST-D, and GAST-O, respectively). The effect of an emergency operation was similar. Age was also identified as a risk factor, but the most suitable modification of age as a variable differed.CONCLUSIONSThe incidence and factors associated with SSI following 3 types of gastric surgery differed. To accurately compare hospital performance in SSI prevention following gastric surgery, dividing surgical procedures in the surveillance system into 3 types should be considered.Infect Control Hosp Epidemiol 2016;1–6

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Risk Factors Associated with Surgical Site Infection in Pediatric Patients Undergoing Spinal Deformity Surgery

JBJS Reviews ◽

10.2106/jbjs.rvw.19.00163 ◽

2020 ◽

Vol 8 (3) ◽

pp. e0163

Author(s):

Hiroko Matsumoto ◽

Matthew E. Simhon ◽

Megan L. Campbell ◽

Michael G. Vitale ◽

Elaine L. Larson

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Spinal Deformity ◽

Pediatric Patients ◽

Site Infection ◽

Factors Associated ◽

Spinal Deformity Surgery

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Risk Factors and Indications for 30-Day Readmission After Primary Surgery for Epithelial Ovarian Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000339 ◽

2015 ◽

Vol 25 (2) ◽

pp. 193-202 ◽

Cited By ~ 10

Author(s):

Mariam AlHilli ◽

Carrie Langstraat ◽

Christine Tran ◽

Janice Martin ◽

Amy Weaver ◽

...

Keyword(s):

Risk Factors ◽

Ovarian Cancer ◽

Postoperative Complications ◽

Epithelial Ovarian Cancer ◽

Odds Ratio ◽

Residual Disease ◽

Factors Associated ◽

Primary Surgery ◽

American Society ◽

American Society Of Anesthesiologists

BackgroundTo identify patients at risk for postoperative morbidities, we evaluated indications and factors associated with 30-day readmission after epithelial ovarian cancer surgery.MethodsPatients undergoing primary surgery for epithelial ovarian cancer between January 2, 2003, and December 29, 2008, were evaluated. Univariable and multivariable logistic regression models were fit to identify factors associated with 30-day readmission. A parsimonious multivariable model was identified using backward and stepwise variable selection.ResultsIn total, 324 (60.2%) patients were stage III and 91 (16.9%) were stage IV. Of all 538 eligible patients, 104 (19.3%) were readmitted within 30 days. Cytoreduction to no residual disease was achieved in 300 (55.8%) patients, and 167 (31.0%) had measurable disease (≤1 cm residual disease). The most common indications for readmission were surgical site infection (SSI; 21.2%), pleural effusion/ascites management (14.4%), and thromboembolic events (12.5%). Multivariate analysis identified American Society of Anesthesiologists score of 3 or higher (odds ratio, 1.85; 95% confidence interval, 1.18–2.89;P= 0.007), ascites [1.76 (1.11–2.81);P= 0.02], and postoperative complications during initial admission [grade 3–5 vs none, 2.47 (1.19–5.16); grade 1 vs none, 2.19 (0.98–4.85); grade 2 vs none, 1.28 (0.74–2.21);P= 0.048] to be independently associated with 30-day readmission (c-index = 0.625). Chronic obstructive pulmonary disease was the sole predictor of readmission for SSI (odds ratio, 3.92; 95% confidence interval, 1.07–4.33;P= 0.04).ConclusionsClinically significant risk factors for 30-day readmission include American Society of Anesthesiologists score of 3 or higher, ascites and postoperative complications at initial admission. The SSI and pleural effusions/ascites are common indications for readmission. Systems can be developed to predict patients needing outpatient management, improve care, and reduce costs.

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Risk factors associated with surgical site infection in 30 491 primary total hip replacements

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.94b10.29184 ◽

2012 ◽

Vol 94-B (10) ◽

pp. 1330-1338 ◽

Cited By ~ 131

Author(s):

R. S. Namba ◽

M. C. S. Inacio ◽

E. W. Paxton

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Site Infection ◽

Factors Associated ◽

Total Hip ◽

Total Hip Replacements ◽

Hip Replacements

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Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery

Surgery Today ◽

10.1007/s00595-007-3637-y ◽

2008 ◽

Vol 38 (5) ◽

pp. 404-412 ◽

Cited By ~ 91

Author(s):

Akihiro Watanabe ◽

Shunji Kohnoe ◽

Rinshun Shimabukuro ◽

Takeharu Yamanaka ◽

Yasunori Iso ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Gastrointestinal Surgery ◽

Site Infection ◽

Factors Associated

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Nursing Evaluation of Risk Factors Associated with Surgical Site Infection Among Coronary Artery Bypass Graft Patients at King Abdulaziz University Hospital

American Journal of Nursing Science ◽

10.11648/j.ajns.20170603.14 ◽

2017 ◽

Vol 6 (3) ◽

pp. 165

Author(s):

Norah Bakheet Al Johani

Keyword(s):

Risk Factors ◽

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Artery Bypass ◽

Bypass Graft ◽

University Hospital ◽

Site Infection ◽

Artery Bypass Graft ◽

Factors Associated ◽

King Abdulaziz University

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Smoking increases the risk of surgical site infection after hydrocelectomy in adults: a retrospective cohort study in Brazil

The Journal of Infection in Developing Countries ◽

10.3855/jidc.9450 ◽

2018 ◽

Vol 11 (12) ◽

pp. 950-956

Author(s):

Thiago Silva Da Costa ◽

Paulo José De Medeiros ◽

Mauro José Costa Salles

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Confidence Interval ◽

Surgical Site Infection ◽

Retrospective Cohort Study ◽

Odds Ratio ◽

Retrospective Cohort ◽

Univariate Analysis ◽

Smoking Habits ◽

Site Infection

Introduction: Surgical site infection (SSI) following hydrocelectomy is relatively uncommon, but it is one of the main post-operative problems. We aimed to describe the prevalence of SSI following hydrocelectomy among adult patients, and to assess predisposing risk factors for infection. Methodology: This retrospective cohort study was carried out at a university hospital and included hydrocelectomies performed between January 2007 and December 2014. Diagnosis of SSI was performed according to the Center for Diseases Control (CDC) guidelines. Multivariable logistic regression analysis was used to identify independent risk factors. Results: A total of 196 patients were included in the analysis. Overall, 30 patients were diagnosed with SSI (15.3%) and of these, 63.3% (19/30) were classified as having superficial SSI, while 36.7% (11/30) had deep SSI. The main signs and symptoms of infection were the presence of surgical wound secretion (70%) and inflammatory superficial signs such as hyperemia, edema and pain (60%). Among the 53 patients presenting chronic smoking habits, 26.4% (14⁄53) developed SSI, which was associated with a higher risk for SSI (odds ratio [OR] = 2.84, 95% confidence interval [CI] = 1.27 to 6.35, p < 0.01) in the univariate analysis. In the adjusted multivariable analysis, smoking habits were also statistically associated with SSI after hydrocelectomy (odds ratio [OR] = 2.84, 95% confidence interval [CI] = 1.30 to 6.24, p = 0.01). No pre-, intra-, or post-operative variable analyzed showed an independent association to SSI following hydrocelectomy. Conclusions: Smoking was the only independent modifiable risk factor for SSI in the multivariate analysis.

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Risk Factors for Methicillin-ResistantStaphylococcus aureusSurgical Site Infection

Infection Control and Hospital Epidemiology ◽

10.1086/590193 ◽

2008 ◽

Vol 29 (9) ◽

pp. 890-893 ◽

Cited By ~ 33

Author(s):

Stephan Harbarth ◽

Benedikt Huttner ◽

Pascal Gervaz ◽

Carolina Fankhauser ◽

Marie-Noelle Chraiti ◽

...

Keyword(s):

Risk Factors ◽

Staphylococcus Aureus ◽

Surgical Site Infection ◽

Immunosuppressive Therapy ◽

Emergency Surgery ◽

Intervention Study ◽

Comorbid Condition ◽

Site Infection ◽

Factors Associated ◽

Surgical Duration

We prospectively evaluated 46 possible risk factors for methicillin-resistantStaphylococcus aureus(MRSA) surgical site infection (SSI) among patients with MRSA carriage in a large intervention study. Of 6,130 study patients, 68 (1.1%) developed MRSA SSI, which occurred a median of 14 days after surgery. Risk factors associated with MRSA SSI were receipt of emergency surgery, presence of comorbid condition, receipt of immunosuppressive therapy, receipt of contaminated surgery, and a surgical duration longer than the 75th percentile. MRSA carriage on admission did not predict MRSA SSI.

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