scholarly journals 1247. Multicenter Study on Risk Factors for Surgical Site Infection After Exploratory Laparotomy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S449-S449
Author(s):  
Túlio Alves Jeangregório Rodrigues ◽  
Guilherme Fernandes de Oliveira ◽  
Júlia G C Dias ◽  
Laís Souza Campos ◽  
Letícia Rodrigues ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Exploratory Laparotomy ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Site Infection ◽  
The Impact

Abstract Background Exploratory laparotomy surgery is abdominal operations not involving the gastrointestinal tract or biliary system. The objective of our study is to answer three questions: (a) What is the risk of surgical site infection (SSI) after exploratory abdominal surgery? (b) What is the impact of SSI in the hospital length of stay and hospital mortality? (c) What are risk factors for SSI after exploratory abdominal surgery? Methods A retrospective cohort study assessed meningitis and risk factors in patients undergoing exploratory laparotomy between January 2013 and December 2017 from 12 hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the National Healthcare Safety Network (NHSN)/CDC procedure-associated protocols for routine SSI surveillance. 26 preoperative and operative categorical and continuous variables were evaluated by univariate and multivariate analysis (logistic regression). Outcome variables: Surgical site infection (SSI), hospital death, hospital length of stay. Variables were analyzed using Epi Info and applying statistical two-tailed test hypothesis with significance level of 5%. Results A sample of 6,591 patients submitted to exploratory laparotomy was analyzed (SSI risk = 4.3%): Hospital length of stay in noninfected patients (days): mean = 16, median = 6, std. dev. = 30; hospital stay in infected patients: mean = 32, median = 22, std. dev. = 30 (P < 0.001). The mortality rate in patients without infection was 14% while hospital death of infected patients was 20% (P = 0.009). Main risk factors for SSI: ügeneral anesthesia (SSI = 4.9%, relative risk – RR = 2.8, P < 0.001); preoperative hospital length of stay more than 4 days (SSI=3.9%, RR=1.8, P = 0.003); wound class contaminated or dirty (SSI = 5.4%, RR = 1.5, P = 0.002); duration of procedure higher than 3 hours (SSI = 7.1%, RR = 2.1, P < 0.001); after trauma laparotomy (SSI = 7.8%, RR = 1.9, P = 0.001). Conclusion We identified patients at high risk of surgical site infection after exploratory laparotomy: trauma patients from contaminated or dirty wound surgery, submitted to a procedure with general anesthesia that last more than 3 hours have 13% SSI. Patients without any of these four risk factors have only 1.2% SSI. Disclosures All authors: No reported disclosures.

Surgical Site Infection After Pediatric Cardiothoracic Surgery

2016 ◽  
Vol 8 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Anthony A. Sochet ◽  
Alexander M. Cartron ◽  
Aoibhinn Nyhan ◽  
Michael C. Spaeder ◽  
Xiaoyan Song ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Surgical Site Infection ◽  
Heart Surgery ◽  
Hospital Costs ◽  
Congenital Heart Surgery ◽  
Hospital Length ◽  
Cardiothoracic Surgery ◽  
Hospital Length Of Stay ◽  
Published Data ◽  
Site Infection

Background: Surgical site infection (SSI) occurs in 0.25% to 6% of children after cardiothoracic surgery (CTS). There are no published data regarding the financial impact of SSI after pediatric CTS. We sought to determine the attributable hospital cost and length of stay associated with SSI in children after CTS. Methods: We performed a retrospective, matched cohort study in a 26-bed cardiac intensive care unit (CICU) from January 2010 through December 2013. Cases with SSI were identified retrospectively and individually matched to controls 2:1 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery category, and primary cardiac diagnosis and procedure. Results: Of the 981 cases performed during the study period, 12 with SSI were identified. There were no differences in demographics, clinical characteristics, or intraoperative data. Median total hospital costs were higher in participants with SSI as compared to controls (US$219,573 vs US$82,623, P < .01). Children with SSI had longer median CICU length of stay (9 vs 3 days, P < .01), hospital length of stay (18 vs 8.5 days, P < .01), and duration of mechanical ventilation (2 vs 1 day, P < .01) and vasoactive administration (4.5 vs 1 day, P < .01). Conclusions: Children with SSI after CTS have an associated increase in hospital costs of US$136,950/case and hospital length of stay of 9.5 days/case. The economic burden posed by SSI stress the importance of infection control surveillance, exhaustive preventative measures, and identification of modifiable risk factors.

scholarly journals Surgical Site Infection After Emergency Abdominal Surgery in China: A Multicenter Prospective Study

2020 ◽  
Author(s):  
Ze Li ◽  
Hui Li ◽  
Pin Lv ◽  
Xingang Peng ◽  
Changliang Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Length Of Stay ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Secondary Outcome ◽  
Microbial Culture ◽  
Site Infection ◽  
High Blood Glucose ◽  
Emergency Abdominal Surgery

Abstract Background There is still a lack of relevant studies on surgical site infection (SSI) after emergency abdominal surgery (EAS) in China. This study aims to understand the status of SSI after EAS in China and discuss its risk factors. Materials and Methods All adult patients who underwent EAS in 47 hospitals in China from May 1 to 31, 2018, and from May 1 to June 7, 2019, were enrolled in this study. The basic information, perioperative data, and microbial culture results of infected incision were prospectively collected.The primary outcome measure was the incidence of SSI after EAS, and the secondary outcome variables were postoperative length of stay, ICU admission rate, ICU length of stay, 30-day postoperative mortality, and treatment costs. Univariate and multivariate logistic regression were used to analyze the risk factors.Results A total of 953 patients (age 48.8 ± 17.9 years, male 51.9%) with EAS were included in this study: 71 patients (7.5%) developed SSI after surgery.The main pathogen of SSI was Escherichia coli (culture positive rate 29.6%). Patients with SSI had significantly longer overall hospital (p < 0.001) and ICU stays (p < 0.001), significantly higher ICU admissions (p < 0.001), and medical costs (p < 0.001) than patients without SSI.Multivariate logistic regression analysis showed that male (P = 0.010), high blood glucose level (P < 0.001), colorectal surgery (P < 0.001), intestinal obstruction (P = 0.045) and surgical duration (P = 0.007) were risk factors for SSI, whereas laparoscopic surgery (P < 0.001 = 0.022) was a protective factor. Conclusion This study found a high incidence of SSI after EAS in China. The occurrence of SSI prolongs the patient's hospital stay and increases the medical burden. The study also revealed predictors of SSI after EAS and provides a basis for the development of norms for the prevention of surgical site infection after emergency abdominal surgery.

scholarly journals 904. Surgical Site Infection After Bariatric Surgery: a Small Risk that Defines Life and Death of Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S486-S486
Author(s):  
Lucca G Giarola ◽  
Carlos Ernesto Ferreira Starling ◽  
Braulio Roberto Gonçalves Marinho Couto ◽  
Handerson Dias Duarte de Carvalho
Keyword(s):  
Bariatric Surgery ◽  
Logistic Regression ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Site Infection ◽  
Belo Horizonte

Abstract Background Surgical site infection (SSI) in bariatric surgery can lead to devastating outcomes such as peritonitis, sepsis, septic shock and organ space infection. The objective of our study is to answer four questions: a) What is the SSI risk after bariatric surgery? b) What are the risk factors for SSI after bariatric surgery? c) What are the main outcomes to SSI in bariatric surgery? d) What are the main bacteria responsible for SSI in bariatric surgery? Methods A retrospective cohort study assessed 8,672 patients undergoing bariatric surgery between 2014/Jan and 2018/Dec from two hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the National Healthcare Safety Network (NHSN)/CDC procedure-associated protocols for routine SSI surveillance. Outcome: SSI, hospital death and total length of hospital stay. 20 preoperative and operative variables were evaluated by univariate and multivariate analysis (logistic regression). Results 77 SSI were diagnosed (risk = 0.9% [C.I.95% = 0.7%;1.1%]). Mortality rate in patients, without infection was only 0.03% (3/8,589) while hospital death of infected patients was 4% (3/77; RR = 112; p&lt; 0.001). Hospital length of stay in non-infected patients (days): mean = 2, std.dev.= 0.9; hospital stay in infected patients: mean = 7, std. dev. = 15.6 (p&lt; 0.001). Two main factors associated with SSI after bariatric surgery were identified by logistic regression: duration of procedure (hours), OR = 1.4;p=0.001, and laparoscopy procedure, OR = 0.3;p=0.020. From 77 SSIs, in 28 (36%) we identified 34 etiologic agents. The majority of SSI (59%) was caused by species of Streptococcus (32%), Klebsiella (15%), and Enterobacter (12%). Conclusion SSI is rare after bariatric surgery, however, when it happens, it’s a disaster for the patient. The incidence of SSI can be reduced significantly when laparoscopy procedure is used and the surgeon is able to perform a rapid surgery. Disclosures All Authors: No reported disclosures

scholarly journals Investigation of Surgical Site Infection Outbreak Among Neurosurgical Patients

2020 ◽  
Vol 41 (S1) ◽  
pp. s306-s306
Author(s):  
Luísa Ramos ◽  
Jussara Pessoa ◽  
Leonardo Santos ◽  
Carlos Starling ◽  
Braulio Couto
Keyword(s):  
Length Of Stay ◽  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Hospital Admissions ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Site Infection ◽  
Epidemic Period ◽  
Neurosurgical Patients ◽  
London Protocol

Background: The infection control service of a private hospital in Belo Horizonte, Brazil, performs continuous surveillance of surgical patients according to the CDC NHSN protocols. In a routine analysis of the neurosurgical service, we identified a subtle increase in the incidence of surgical site infection (SSI): in 5 months (June–October 2018), 6 patients developed an SSI. From January 2017 until May 2018, there were no cases of infection in neurosurgery, which led us to suspect an outbreak. Methods: A cohort study was used to investigate the factors associated with risk of SSI. We investigated the following variables: ASA score, number of hospital admissions, age, preoperative hospital length of stay, duration of surgery, wound class, general anesthesia, emergency, trauma, prosthesis, surgical procedures, surgeon. Furthermore, 9 key steps were followed to investigate the outbreak: case definition (step 1), search for new SSI cases (step 2); confirmation of the outbreak (step 3); analysis of SSI cases by London Protocol (step 4); analysis of the cohort data (step 5); inspections in the surgical ward (step 6); qualitative and quantitative reports sent to the neurosurgical departments (step 7); continuing with active surveillance (stage 8); announcement of research findings (step 9). Results: The outbreak was confirmed: SSI incidence in the pre-epidemic period (January–May 2018) was 0 of 218 (0%); in the epidemic period (June–October 2018), SSI incidence was 6 of 94 (6.4%) (P < .001). We identified 3 SSI etiologic agents: 2 Klebsiella pneumoniae, 2 S. aureus, and 1 Serratia marcescens. It was unlikely that there was a common source for the outbreak. We identified the following risk factors: second or third hospital admissions (RR, 3.7; P = .041), and preoperative hospital length of stay: SSI patients (4.3±5.7 days) versus control patients (0.7 ± 2.1 days) (P = .048). None of the surgeons presented an SSI rate significantly different from each other. We used the London protocol to identify antibiotic prophylaxis failures in most cases. Conclusions: New cases of infections can be prevented if the length of preoperative hospital stay becomes as short as possible and, most importantly, if antibiotic prophylaxis does not fail.Funding: NoneDisclosures: None

scholarly journals Prospective multicenter study on the incidence of surgical site infection after emergency abdominal surgery in China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ze Li ◽  
Hui Li ◽  
Pin Lv ◽  
Xingang Peng ◽  
Changliang Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Length Of Stay ◽  
Abdominal Surgery ◽  
Surgical Site Infection ◽  
Secondary Outcome ◽  
Site Infection ◽  
Multivariate Logistic Regression ◽  
High Blood Glucose ◽  
Emergency Abdominal Surgery

AbstractThere is still a lack of relevant studies on surgical site infection (SSI) after emergency abdominal surgery (EAS) in China. This study aims to understand the incidence of SSI after EAS in China and discuss its risk factors. All adult patients who underwent EAS in 47 hospitals in China from May 1 to 31, 2018, and from May 1 to June 7, 2019, were enrolled in this study. The basic information, perioperative data, and microbial culture results of infected incision were prospectively collected. The primary outcome measure was the incidence of SSI after EAS, and the secondary outcome variables were postoperative length of stay, ICU admission rate, ICU length of stay, 30-day postoperative mortality, and hospitalization cost. Univariate and multivariate logistic regression were used to analyze the risk factors. The results were expressed as the odds ratio and 95% confidence interval. A total of 953 patients [age 48.8 (SD: 17.9), male 51.9%] with EAS were included in this study: 71 patients (7.5%) developed SSI after surgery. The main pathogen of SSI was Escherichia coli (culture positive rate 29.6%). Patients with SSI had significantly longer overall hospital (p < 0.001) and ICU stays (p < 0.001), significantly higher ICU admissions (p < 0.001), and medical costs (p < 0.001) than patients without SSI. Multivariate logistic regression analysis showed that male (P = 0.010), high blood glucose level (P < 0.001), colorectal surgery (P < 0.001), intestinal obstruction (P = 0.045) and surgical duration (P = 0.007) were risk factors for SSI, whereas laparoscopic surgery (P < 0.001) was a protective factor. This study found a high incidence of SSI after EAS in China. The occurrence of SSI prolongs the patient's hospital stay and increases the medical burden. The study also revealed predictors of SSI after EAS and provides a basis for the development of norms for the prevention of surgical site infection after emergency abdominal surgery.

scholarly journals 892. Meningitis after Ventricular Shunt Operations: Multicenter Study to Identify Etiology, Incidence and Risk Factors

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S481-S481
Author(s):  
Lucca G Giarola ◽  
Handerson Dias Duarte de Carvalho ◽  
Braulio Roberto Gonçalves Marinho Couto ◽  
Carlos Ernesto Ferreira Starling
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Hospital Admission ◽  
Hospital Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Communicating Hydrocephalus ◽  
Increased Risk ◽  
Belo Horizonte

Abstract Background A Ventriculoperitoneal shunt is the main treatment for communicating hydrocephalus. Surgical site infection associated with the shunt device is the most common complication and an expressive cause of morbidity and mortality of the treatment. The objective of our study is to answer three questions: a)What is the risk of meningitis after ventricular shunt operations? b) What are the risk factors for meningitis? c) What are the main microorganisms causing meningitis? Methods A retrospective cohort study assessed meningitis and risk factors in patients undergoing ventricular shunt operations between 2015/Jul and 2018/Jun from 12 hospitals at Belo Horizonte, Brazil. Data were gathered by standardized methods defined by the National Healthcare Safety Network (NHSN)/CDC procedure-associated protocols for routine SSI surveillance. Sample size = 926. 26 variables were evaluated by univariate and multivariate analysis (logistic regression). Results 71 patients were diagnosed with meningitis which represent a risk of 7.7% (C.I.95%= 6.1%; 9.6%). From the 26 variables, three were acknoleged as risk factors: age &lt; two years old (OR = 3.20; p &lt; 0.001), preoperative hospital length of stay &gt; four days (OR = 2.02; p = 0.007) and more than one surgical procedure (OR = 3.23; p = 0.043). Patients two or more years old, who had surgery four days after hospital admission, had increased risk of meningitis from 4% to 6% (p = 0.140). If a patient &lt; two years had surgery four days post hospital admission, the risk is increased from 9% to 18% (p = 0.026). 71 meningitis = &gt; 45 (63%) the etiologic agent identified: Staphylococcus aureus (33%), Staphylococcus epidermidis (22%), Acinetobacter sp (7%), Enterococcus sp (7%), Pseudomonas sp (7%), and other (18%). Hospital length of stay in non-infected patients (days): mean = 21 (sd = 28), median = 9; hospital stay in infected patients: mean = 34 (sd = 37), median = 27 (p=0.025). Mortality rate in patients without infection was 10% while hospital death of infected patients was 13% (p=0.544). Conclusion Two intrinsic risk factors for meningitis post ventricular shunt, age under two years old and multiple surgeries, and one extrinsic risk factor, preoperative length of hospital stay, were identified. Incidence of meningitis post VP shunt decreases with urgent surgical treatment. Disclosures All Authors: No reported disclosures

scholarly journals Predicting Hospital Length of Stay at Admission Using Global and Country-Specific Competing Risk Analysis of Structural, Patient, and Nutrition-Related Data from nutritionDay 2007–2015

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4111
Author(s):  
Noemi Kiss ◽  
Michael Hiesmayr ◽  
Isabella Sulz ◽  
Peter Bauer ◽  
Georg Heinze ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Proportional Hazards ◽  
Patient Characteristics ◽  
Hospital Length ◽  
Cox Proportional Hazards ◽  
Hospital Length Of Stay ◽  
Hospital Death ◽  
Event Analysis ◽  
Related Data ◽  
The Impact

Hospital length of stay (LOS) is an important clinical and economic outcome and knowing its predictors could lead to better planning of resources needed during hospitalization. This analysis sought to identify structure, patient, and nutrition-related predictors of LOS available at the time of admission in the global nutritionDay dataset and to analyze variations by country for countries with n > 750. Data from 2006–2015 (n = 155,524) was utilized for descriptive and multivariable cause-specific Cox proportional hazards competing-risks analyses of total LOS from admission. Time to event analysis on 90,480 complete cases included: discharged (n = 65,509), transferred (n = 11,553), or in-hospital death (n = 3199). The median LOS was 6 days (25th and 75th percentile: 4–12). There is robust evidence that LOS is predicted by patient characteristics such as age, affected organs, and comorbidities in all three outcomes. Having lost weight in the last three months led to a longer time to discharge (Hazard Ratio (HR) 0.89; 99.9% Confidence Interval (CI) 0.85–0.93), shorter time to transfer (HR 1.40; 99.9% CI 1.24–1.57) or death (HR 2.34; 99.9% CI 1.86–2.94). The impact of having a dietician and screening patients at admission varied by country. Despite country variability in outcomes and LOS, the factors that predict LOS at admission are consistent globally.

Shorter Duration of Femoral-Popliteal Bypass Is Associated with Decreased Surgical Site Infection and Shorter Hospital Length of Stay

2012 ◽  
Vol 215 (4) ◽  
pp. 512-518 ◽  
Author(s):  
Tze-Woei Tan ◽  
Jeffrey A. Kalish ◽  
Naomi M. Hamburg ◽  
Denis Rybin ◽  
Gheorghe Doros ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Surgical Site Infection ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Site Infection
Sign in / Sign up

Export Citation Format

Share Document