scholarly journals Risk factors for pediatric surgical site infection following neurosurgical procedures for hydrocephalus: a retrospective single-center cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Miho Shibamura-Fujiogi ◽  
Jennifer Ormsby ◽  
Mark Breibart ◽  
Benjamin Warf ◽  
Gregory P. Priebe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Surgical Site Infection ◽  
Cardiac Disease ◽  
Neurosurgical Procedures ◽  
Site Infection ◽  
Beta Lactam ◽  
Perioperative Prophylaxis ◽  
Number Of Patients ◽  
Csf Diversion

Abstract Background Infection is a major complication following cerebral spinal fluid (CSF) diversion procedures for hydrocephalus. However, pediatric risk factors for surgical site infection (SSI) are currently not well defined. Because a SSI prevention bundle is increasingly introduced, the purpose of this study was to evaluate risk factors associated with SSIs following CSF diversion surgeries following a SSI bundle at a single quaternary care pediatric hospital. Methods We performed a retrospective cohort study of patients undergoing CSF diversion procedures from 2017 to 2019. SSIs were identified prospectively through continuous surveillance. We performed unadjusted logistic regression analyses and univariate analyses to determine an association between SSIs and patient demographics, comorbidities and perioperative factors to identify independent risk factors for SSI. Results We identified a total of 558 CSF diversion procedures with an overall SSI rate of 3.4%. The SSI rates for shunt, external ventricular drain (EVD) placement, and endoscopic third ventriculostomy (ETV) were 4.3, 6.9 and 0%, respectively. Among 323 shunt operations, receipt of clindamycin as perioperative prophylaxis and presence of cardiac disease were significantly associated with SSI (O.R. 4.99, 95% C.I. 1.27–19.70, p = 0.02 for the former, and O.R. 7.19, 95% C.I. 1.35–38.35, p = 0.02 for the latter). No risk factors for SSI were identified among 72 EVD procedures. Conclusion We identified receipt of clindamycin as perioperative prophylaxis and the presence of cardiac disease as risk factors for SSI in shunt procedures. Cefazolin is recommended as a standard antibiotic for perioperative prophylaxis. Knowing that unsubstantiated beta-lactam allergy label is a significant medical problem, efforts should be made to clarify beta-lactam allergy status to maximize the number of patients who can receive cefazolin for prophylaxis before shunt placement. Further research is needed to elucidate the mechanism by which cardiac disease may increase SSI risk after shunt procedures.

scholarly journals Risk Factors for Pediatric Surgical Site Infection Following Neurosurgical Procedures for Hydrocephalus: A Retrospective Single-Center Cohort Study

2021 ◽  
Author(s):  
Miho Shibamura-Fujiogi ◽  
Jennifer Ormsby ◽  
Mark Breibart ◽  
Benjamin Warf ◽  
Thomas Sandora ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Brain Tumor ◽  
Surgical Site Infection ◽  
Cardiac Disease ◽  
Connective Tissue Diseases ◽  
Neurosurgical Procedures ◽  
Site Infection ◽  
Csf Diversion ◽  
Univariate Analyses

Abstract Background Infection is a major complication following cerebral spinal fluid (CSF) diversion procedures for hydrocephalus. However, their pediatric risk factors for surgical site infection (SSI) are currently not well defined. Because SSI prevention bundle is increasingly introduced, the purpose of this study was to evaluate risk factors associated with SSIs following CSF diversion surgeries under SSI bundle at a single quaternary care pediatric hospital.Methods We performed a retrospective cohort study of patients undergoing CSF diversion procedures from 2017 to 2019. SSIs were identified prospectively through continuous surveillance. We performed univariate analyses to determine an association between SSIs and patient demographics, comorbidities and perioperative factors, with subsequent multivariate logistic regression analyses to identify independent risk factors for SSI.Results We identified a total of 561 CSF diversion procedures with an overall SSI rate of 3.6%. In univariate analyses, older age, number of previous shunt revisions and comorbid cardiac disease were significantly associated with SSI. In multivariate analyses, history of brain tumor (OR2.75, 95%CI 1.03-7.33, P=0.04) and cardiac comorbidities (OR9.47, 95%CI 2.15-41.73, P=0.003) were significantly associated with SSIs. When endoscopic third ventriculostomy was excluded, only cardiac disease was independently associated with SSI. Cardiac diseases associated with SSI included single ventricle disease with palliative repair and valvulopathy with underlying connective tissue diseases. Conclusion This study showed that comorbid conditions (cardiac disease, brain tumor) were more important than perioperative factors as risk factors for SSI in pediatric patients undergoing CSF diversion procedures. Further investigation is needed to define the mechanisms behind these associations.

scholarly journals Assessment of risk factors for surgical site infection following caesarean section

2019 ◽  
Vol 8 (11) ◽  
pp. 4518
Author(s):  
Aditi Sangwan ◽  
Vani Malhotra
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
Site Infection ◽  
Emergency Caesarean ◽  
Group I ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Wound Discharge ◽  
Group Ii

Background: Assessment of surgical site infection is an important factor to determine the functioning of the health care system. Objectives of this study was to estimate the incidence of surgical site infection among caesarean section cases and to determine the risk factors associated with surgical site infection and comparison with patients having healthy wounds.Methods: One thousand pregnant women who underwent caesarean section were divided into two groups: Group 1 (cases): Those who had SSI within 30 days of caesarean section and Group 2 (controls): Those who didn’t have SSI.Results: Mean age of group I was 25.35±4.40 and 21.12±3.60 years in group II (p >0.05). Mean gestational age of group I cases was 38.07±1.88 weeks and in group II, it was 38.17±2.06 weeks (p >0.05). A total of 37 (82.5%) women in group I and 931 (96.98%) women in group II underwent emergency caesarean section (p <0.05). In group I, mean duration of surgery was 1.0±0.13 hours and 1.02±0.21 hours in group II (p <0.05). Maximum number of patients i.e. 22 (55%) had wound discharge between 4-7 days followed by 11 (27.5%) between 8-10 days. Mean wound discharge was 7.32±3.45 days in group I. Majority of women, i.e. 27 (67%) found to be sterile in the present study followed by 7 (17.5%) women were found to have staphylococcus aureus.      Mean duration of resuturing was 17.42±6.98 days.  Mean baby weight in group I was 2.72±0.53 kg and in group II it was 2.95±0.53 kg (p <0.001).Conclusions: Risk of developing SSI after caesarean section is multi-factorial and found to be influenced by emergency surgery, PROM, pre-operative anaemia, multiple vaginal examinations, interrupted skin suturing, raised BMI, nulliparity, emergency caesarean, duration of surgery.

scholarly journals Surgical site infection after hip fracture – mortality and risk factors: an observational cohort study of 1,709 patients

2020 ◽  
Vol 91 (3) ◽  
pp. 347-352 ◽  
Author(s):  
Christian T Pollmann ◽  
Fredrik A Dahl ◽  
Jan Harald M Røtterud ◽  
Jan-Erik Gjertsen ◽  
Asbjørn Årøen
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Hip Fracture ◽  
Surgical Site Infection ◽  
Observational Cohort Study ◽  
Site Infection ◽  
Observational Cohort ◽  
Hip Fracture Mortality

Epidemiological Surveillance of Surgical Site Infection and its Risk Factors in Cardiac Surgery: A Prospective Cohort Study

2016 ◽  
Vol 69 (9) ◽  
pp. 842-848
Author(s):  
Angels Figuerola-Tejerina ◽  
Gil Rodríguez-Caravaca ◽  
Juan Bustamante-Munguira ◽  
Jesús María San Román-Montero ◽  
Manuel Durán-Poveda
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cohort Study ◽  
Surgical Site Infection ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Epidemiological Surveillance ◽  
Site Infection

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

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.

scholarly journals Risk Stratification for Organ/Space Surgical Site Infection in Digestive System Cancer: A Prospective Cohort Study

2021 ◽  
Author(s):  
Chen Sun ◽  
Hui Gao ◽  
Yuelun Zhang ◽  
Lijian Pei ◽  
Yuguang Huang
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Risk Stratification ◽  
Surgical Site Infection ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Digestive System ◽  
Site Infection ◽  
Digestive System Cancer ◽  
Risk Stratification Score

Abstract Background: Organ/space surgical site infection (organ/space SSI) is one of the serious postoperative complications, closely related to a poor prognosis. Few studies have attempted to design risk scoring systems for patients with digestive system cancer. This study aimed to develop a simple and practical risk stratification score for these patients to identify a priori risk of organ/space SSI.Methods: This prospective cohort study was based on two prospective studies (NCT02756910, ChiCTR-IPR-17011099), including patients undergoing elective radical resection of digestive system cancer. Logistic regression analysis was used to identify the determinant variables. The incidence of organ/space SSI stratified over perioperative factors was compared and compounded in a risk score.Results: Among the 839 patients, 51 developed organ/space SSI (6.1%) within 30 days after surgery. Patients undergoing gastrectomy (OR=8.466, 95% CI: 2.728-26.270, P<0.001), colorectal resection (OR=11.180, 95% CI: 3.921-31.881, P<0.001) and pancreatoduodenectomy (OR=9.054, 95% CI: 3.329-24.624, P<0.001) with an anaesthesia time > 4 h (OR=2.335, 95% CI: 1.035-5.271, P=0.041) and prolonged intensive care unit (ICU) stays > 24 h (OR=4.243, 95% CI: 1.715-10.498, P=0.002) had a significantly higher risk of organ/space SSI. These risk factors (procedure type, anaesthesia time, prolonged ICU stays) were also associated with an increase in organ/space SSI rates based on a compounded score (P<0.001). Comparisons with the overall population revealed that patients with 0 or 1 risk factor (n=602) had an organ/space SSI rate of 2.8% (RR=0.197, 95% CI: 0.112-0.345), those with 2 risk factors (n=223) had an organ/space SSI rate of 13.0% (RR=3.641; 95% CI: 2.138-6.202), and those with 3 risk factors (n=14) had an organ/space SSI rate of 35.7% (RR=6.405, 95% CI: 3.005-13.653).Conclusion: The risk stratification score in this study provides a simple and practical tool to stratify patients with digestive system cancer so that the relative risk of developing postoperative organ/space SSIs can be predicted.Trial Registration: This study was based on one randomized controlled trial (NCT02756910) registered at ClinicalTrials.gov on April 29, 2016 and one prospective cohort study (ChiCTR-IPR-17011099) registered at the Chinese Clinical Trial Registry on April 9, 2017.

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