scholarly journals Incidence and risk factors of surgical site infection following colorectal surgery in China: a national cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xufei Zhang ◽  
Zhiwei Wang ◽  
Jun Chen ◽  
Peige Wang ◽  
Suming Luo ◽  
...  

Abstract Purposes Surgical site infection (SSI) after colorectal surgery is a frequent complication associated with the increase in morbidity, medical expenses, and mortality. To date, there is no nationwide large-scale database of SSI after colorectal surgery in China. The aim of this study was to determine the incidence of SSI after colorectal surgery in China and to further evaluate the related risk factors. Methods Two multicenter, prospective, cross-sectional studies covering 55 hospitals in China and enrolling adult patients undergoing colorectal surgery were conducted from May 1 to June 30 of 2018 and the same time of 2019. The demographic and perioperative characteristics were collected, and the main outcome was SSI within postoperative 30 days. Multivariable logistic regressions were conducted to predict risk factors of SSI after colorectal surgery. Results In total, 1046 patients were enrolled and SSI occurred in 74 patients (7.1%). In the multivariate analysis with adjustments, significant factors associated with SSI were the prior diagnosis of hypertension (OR, 1.903; 95% confidence interval [CI], 1.088–3.327, P = 0.025), national nosocomial infection surveillance risk index score of 2 or 3 (OR, 3.840; 95% CI, 1.926–7.658, P < 0.001), laparoscopic or robotic surgery (OR, 0.363; 95% CI, 0.200–0.659, P < 0.001), and adhesive incise drapes (OR, 0.400; 95% CI, 0.187–0.855, P = 0.018). In addition, SSI group had remarkably increased length of postoperative stays (median, 15.0 d versus 9.0d, P < 0.001), medical expenses (median, 74,620 yuan versus 57,827 yuan, P < 0.001), and the mortality (4.1% versus 0.3%, P = 0.006), compared with those of non-SSI group. Conclusion This study provides the newest data of SSI after colorectal surgery in China and finds some predictors of SSI. The data presented in our study can be a tool to develop optimal preventive measures and improve surgical quality in China.

2021 ◽  
Author(s):  
Siamak Rajaei ◽  
Masoud Mohammadi ◽  
Mohammad Hosein Taziki Balajelini ◽  
Reza Afghani ◽  
Mehrshad Zare ◽  
...  

Abstract Background Surgical site infection (SSI) after colorectal surgery remains a significant problem for its negative clinical outcomes. The aim of this study was to determine the incidence of SSI after colorectal surgery in 5-Azar hospital of Gorgan, Golestan province, Iran and to further evaluate the related risk factors. Methods A prospective design was applied. Patients in the 5-Azar hospital of Gorgan, Golestan province, Iran was prospectively monitored for SSI after colorectal surgery. The demographic and perioperative characteristics were collected, and the main outcome were SSI within postoperative 30 days. Univariate analyses were used to identify risk factors. Results A total of 240 patients were enrolled in the study and the overall SSI rate was 23.3% (56 patients). Univariate analyses indicated that corticosteroids use (Risk Ratio (RR) = 3, 95% CI: 1.62–5.54), segmental resection with anastomosis (RR = 2.28, 95% CI: 1.12–4.63), anemia (RR = 4.52, 95% CI: 3.11–6.59), diabetics (RR = 2.68, 95% CI: 1.73–4.14), and opium use (RR = 1.87, 95% CI: 1.17–2.99) are risk factors for SSI. Conclusions SSI still seems to be a problem in colon surgery despite the observance of scientific principles. There are some risk factors for SSI that can be prevented.


2020 ◽  
Author(s):  
Yu Zhang ◽  
Hui-Quan Gan ◽  
Jing-Fang Zhou ◽  
Ya-Jie Gong ◽  
Liu-Yi Li ◽  
...  

Abstract Background: Surgical site infection (SSI) after colorectal surgery (CRS) remains a significant problem for its negative clinical outcomes. However, it is poorly understood in China . This study aims to investigate the prevalence, risk factors and microbiology of SSI after CRS. Methods: A nationwide prospective multicenter design was applied. Patients in 19 Chinese hospitals from 2015 to 2018 were prospectively monitored for SSI after CRS. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using univariate and multivariate logistic regression models. Results: Among 3,663 study participants, 134(3.66%) episodes of SSI were identified. The prevalence rate of SSI decreased from 5.9 infections per 100 procedures in 2014 to 3.1 infections per 100 procedures in 2017 (prevalence rate ratio [PRR], 0.52; 95% CI, 0.28–0.94). The SSI rates were 1.88, 4.15, 6.27 and 11.58 per 100 operations for the National Nosocomial Infections Surveillance system (NNIS) risk index categories of 0, 1, and 2 or 3, respectively. Escherichia coli (54/134, 40.3%) and Klebsiella pneumoniae (10/134, 7.5%) were the most frequently isolated microorganisms. A high prevalence of antibiotic resistance were observed in our study, with rates of extended spectrum beta-lactamase-producing or carbapenem-resistant Escherichia coli and Klebsiella pneumonia of 50.0%(27/54) and 30.0%(3/10) respectively. Preoperative hospital stay ≥ 48h (OR=2.28, 95% CI: 1.03–5.02) and contaminated or dirty wound (OR=3.38, 95% CI: 1.88–6.06) were significantly associated with increasing risk of SSI after CRS. Conclusion: A statistically significant but modest decrease in the prevalence rate of CRS SSI over the 4-year study period was observed in this study. Noticeably, the relatively high rates of multidrug-resistant pathogens causing SSI after CRS should be alert despite of the small number of isolates identified in our survey.


MedPharmRes ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 19-22
Author(s):  
Vo Truong Quoc ◽  
Phan Minh Tri

Introduction: Pancreaticoduodenectomy has been a radical treatment for periampullary carcinoma, which is a collection of malignant neoplasia of the periampullary region. Although the mortality has declined dramatically, the complications are still high. This study aims to determine the occurring rate of short-term complications after pancreaticoduodenectomy and to identify the risk factors related to those complications. Comprehension of these problems help increase the outcome. Materials and Method: It is a cross-sectional study of the patients with periampullary cancer, who undergo pancreaticoduodenectomy at Cho Ray Hospital from January 2012 to October 2016. Results: Overall complication rate was 25.65% from 230 patients. In which, pancreatic fistula and surgical site infection were the two most frequent complication (10.43% and 4.38% respectively). Pancreatic fistula was highly significantly associated with Wirsung’s duct diameter less than 3 mm (p = 0.015) and soften pancreatic parenchyma (p = 0.004). The soften pancreatic parenchyma also increased the risk of surgical site infection (OR 4.588), but it was not statistically significant (p = 0.056). Soften pancreatic parenchyma increased the haemorrhage complication significantly (p = 0.04) (OR: 10,668, 95% confidence). Discussions: Pancreatic main duct’s diameter, pancreatic density and Hemoglobin may relate to the early postoperative complications following pancreaticoduodenectomy. Detailedly, in particular for pancreatic fistula, 2 risk factors recognized are Wirsung’s diameter less than 3mm and soft pancreatic density. Meanwhile low concentration of hemoglobin in blood may increase the risk of incisional infection. Pancreatic density related to the complication of haemorrhage. Conclusions: Short-term complications’ rate following pancreatoduodenectomy remains high. Understanding the risk factors help us choose which case should be operated and do pre-operative preparation better.


Author(s):  
Waleed Awwad ◽  
Abdullah Alnasser ◽  
Abdulrahman Almalki ◽  
Rohail Mumtaz ◽  
Bander Alsubaie ◽  
...  

Introduction: Surgical site infection (SSI) is a major cause of morbidity and mortality as it is known to increase the length of hospital stay, revision surgery, and re-operation. Identifying patients at risk of developing SSI before surgery is the key to prevent SSI. Methodology: This cross-sectional study was performed at the orthopedic department in King Khalid University Hospital, Riyadh, Saudi Arabia. SSIs were defined according to the Centers for Disease Control (CDC) case definition for SSI. Potential risk factors for postoperative wound infection were collected. Data were analyzed using the SPSS, version 23.0, and p-value < 0.05 was considered to be statistically significant. Result: A total of 214 patients were included in the study and the incidence of SSI following spine surgery was 9.81% (N = 21). Obesity, diabetes, location of surgery, ASA score, duration of surgery, length of hospital stay, and location/level of operated vertebrae were all found to have a significant correlation with the SSI (p < 0.05). Conclusion: Having a strong background of SSI risk factors and predictors is core to preventing the incidence of SSI and further enhance and optimize operative outcomes, as well as increasing the cost-effectiveness of the surgical intervention.


Author(s):  
Niaz Hussain Keerio ◽  
Ghazanfar Ali Shah ◽  
Tanveer Afzal ◽  
Aftab Alam Khanzada ◽  
Muhammad Rafique Joyo ◽  
...  

Objective: To determine the incidence of surgical site infection among patients with hip fracture and undergo a surgical procedure for management. And to spotlight on the risk factors which may lead to surgical site infection among them. Also, to look for other complications following the surgery. Methods: This is a descriptive, correlational cross-sectional study design. The study was conducted at Orthopedic Department, Mohammad Medical College and Hospital Mirpurkhas, Pakistan for one-year duration from March 2019 to March 2020. All patients had hip fracture and received management at the department of orthopedic. All patients were adults and older than 20 years of age. Data was analyzed using SPSS program. Results: The study included 103 patients who had hip fractures. The most frequent age group was 40-50 years. Patients had a mix of modifiable and non-modifiable risk factors for developing surgical site infection. The incidence rate of surgical site infection in this study was 3.2%. It was correlated to having hypertension and diabetes as complications. Conclusion: This study aimed to spotlight on the SSI following hip surgeries and to look for complications and risk factors. We noticed that the SSI rate among the study populations is almost similar as the worldwide range. This is due to the agreed protocol for managing patients. However, there is a need for log-term follow up for our patient to discover the cases of delayed SSI.


2019 ◽  
Vol 4 (2) ◽  
pp. 45-49
Author(s):  
Humberto Guanche Garcell ◽  
Ariadna Villanueva Arias ◽  
Cristobal A. Pancorbo Sandoval ◽  
Adan Bode Sado ◽  
Ramón Nonato Alfonso Serrano ◽  
...  

Background: Identifying risk factors for surgical site infection (SSI) after appendectomies could be useful in focusing prevention programs. Objective: The current study aimed to identify the risk factors associated with SSI in a cohort of patients from a single center in Western Qatar. Methods: This cross-sectional study was carried out at The Cuban Hospital (Dukhan, Qatar) on patients who had undergone an appendectomy from January 2013 through September 2016. Data extracted from the patient files included demographics, comorbidities and toxic habits, surgery type, procedure duration, wound type, appendicitis-type, American Anesthesiology Score, body mass index, selected laboratory tests, and compliance with antibiotic prophylaxis. Results: The study variables, type of surgery performed, procedure duration, wound and appendicitis type, serum albumin, and timing of antibiotic prophylaxis, were found to be related to the occurrence of SSI in univariate analysis (P = 0.000). Logistic regression showed that open appendectomies (odds ratio [OR] = 22.90, 95% CI; 8.04-65.21), low serum albumin (OR = 0.92, 95% CI; 0.85-0.99), and improper timing of antibiotic prophylaxis (OR = 44.92, 95% CI; 3.39-594.91) were independently associated with the occurrence of SSI. Conclusion: Cases of complex appendicitis, open procedure, low serum albumin level, and improper timing of antibiotic prophylaxis constituted the risk factors for SSI in the setting of this study. The infection control program should focus on improving the quality of antibiotic prophylaxis and closely monitoring patients who undergo open surgical procedures.


2020 ◽  
Vol 19 ◽  
pp. 1-13
Author(s):  
Luis David Berrones Sanz ◽  
María Guadalupe de Dios Bravo ◽  
Exiquio Cesar González Peña ◽  
Victoria Alejandra Muro Báez

From the perspective of social reproduction, the focus of this study is placed on the collective practice of diet in bike taxi drivers (or rickshaws) of Mexico City’s historic downtown, analyzed as key element in a characteristic pathologic profile observed in health/disease conditions, particularly as the cause for overweight, obesity, dyslipidemias, and factors associated to metabolic syndrome. A descriptive, cross-sectional study was conducted with 110 (90.2%) drivers. A survey was used to collect data on diet habits, working conditions and lifestyle. Anthropometric measurements and blood samples were taken to analyze biochemical parameters in order to assess the subjects’ health status and establish obesity-related risk factors. The results reveal that average daily soda consumption is 1.6 liters (54 fl. oz.), an equivalent of 629 kilocalories per day. Vegetables are consumed 3.1 times per week and 65.7 kilograms (145 pounds) of corn tortillas are consumed per year. Obesity is associated to the number of years a person has been driving a bike taxi [χ2(2, N = 99) = 6.747, p = 0.034]. 69.1% is overweight or obese, 63.3% has hypertriglyceridemia and 49.1% meet three or more criteria to be diagnosed with metabolic syndrome according to the Adult Treatment Panel III (ATP III). Drivers’ intake of sugary drinks and junk food is high, while recommended food intake like vegetables, fruits, legumes and white meat is low. Ongoing campaigns are recommended to promote healthy food intake, avoid sugary drinks intake and facilitate water consumption.


2021 ◽  
Vol 62 (5) ◽  
Author(s):  
Tran Quynh Anh ◽  
Bui Van Tung ◽  
Nguyen Tuan Tai ◽  
Chu Van Thang ◽  
Dang Duc Hoan ◽  
...  

Objective: Description of knowledge on prevention of surgical site infections (SSIs) among medical staff in Son Tay general hospital, 2021 and some related factors.Method: A cross-sectional study was conducted on 151 medical staff.Results: The rate of medical staff with fully knowledge of SSI prevention is 36.42%, in which the rate of doctors is 38.3% and of nurses is 35.58%. Age group ≥30 (OR=2.82; 95%CI: 1.12 – 7.13);Department of Surgery (OR=13.61; 95%CI: 5.14 – 35.98); working year ≥10 (OR=2.54; 95%CI: 1.26 – 5.11) and number of patients cared for/day <8 (OR=3.43; 95%CI: 1.26 – 9 ,34) are factorsrelated to the knowledge of medical staff about regarding SSIs.Conclusion: The medical staff’s knowledge of surgical site infection prevention is suboptimal; relevant factors should be considered when conducting ongoing training in the prevention of surgical site infections in hospitals.


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