Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery

Background: organ-space surgical site infections (SSI) are the most serious and costly infections after colorectal surgery. Most previous studies of risk factors for SSI have analysed colon and rectal procedures together. The aim of the study was to determine whether colon and rectal procedures have...

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Autores: Gomila Grange, Aina, Carratalà, Jordi, Camprubí Ferrer, Daniel, Shaw Perujo, Evelyn, Badia, Josep M., Cruz, Antoni, Aguilar, Francesc, Nicolás, Carmen, Marron, Anna, Mora, Laura, Pérez, Rafel, Martín, Lydia, Vázquez, Rosa, López, Ana Felisa, Limón, Enrique, Gudiol i Munté, Francesc, Pujol Rojo, Miquel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/128585
Acceso en línea:https://hdl.handle.net/2445/128585
Access Level:acceso abierto
Palabra clave:Cirurgia colorectal
Infeccions quirúrgiques
Factors de risc en les malalties
Colorectal surgery
Surgical wound infection
Risk factors in diseases
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spelling Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgeryGomila Grange, AinaCarratalà, JordiCamprubí Ferrer, DanielShaw Perujo, EvelynBadia, Josep M.Cruz, AntoniAguilar, FrancescNicolás, CarmenMarron, AnnaMora, LauraPérez, RafelMartín, LydiaVázquez, RosaLópez, Ana FelisaLimón, EnriqueGudiol i Munté, FrancescPujol Rojo, MiquelCirurgia colorectalInfeccions quirúrgiquesFactors de risc en les malaltiesColorectal surgerySurgical wound infectionRisk factors in diseasesBackground: organ-space surgical site infections (SSI) are the most serious and costly infections after colorectal surgery. Most previous studies of risk factors for SSI have analysed colon and rectal procedures together. The aim of the study was to determine whether colon and rectal procedures have different risk factors and outcomes for organ-space SSI. Methods: a multicentre observational prospective cohort study of adults undergoing elective colon and rectal procedures at 10 Spanish hospitals from 2011 to 2014. Patients were followed up until 30 days post-surgery. Surgical site infection was defined according to the Centers for Disease Control and Prevention criteria. Oral antibiotic prophylaxis (OAP) was considered as the administration of oral antibiotics the day before surgery combined with systemic intravenous antibiotic prophylaxis. Results: of 3,701 patients, 2,518 (68%) underwent colon surgery and 1,183 (32%) rectal surgery. In colon surgery, the overall SSI rate was 16.4% and the organ-space SSI rate was 7.9%, while in rectal surgery the rates were 21.6% and 11.5% respectively (p < 0.001). Independent risk factors for organ-space SSI in colon surgery were male sex (Odds ratio -OR-: 1.57, 95% CI: 1.14-2.15) and ostomy creation (OR: 2.65, 95% CI: 1.8-3.92) while laparoscopy (OR: 0.5, 95% CI: 0.38-0.69) and OAP combined with intravenous antibiotic prophylaxis (OR: 0.7, 95% CI: 0.51-0.97) were protective factors. In rectal surgery, independent risk factors for organ-space SSI were male sex (OR: 2.11, 95% CI: 1.34-3.31) and longer surgery (OR: 1.49, 95% CI: 1.03-2.15), whereas OAP with intravenous antibiotic prophylaxis (OR: 0.49, 95% CI: 0.32-0.73) was a protective factor. Among patients with organ-space SSI, we found a significant difference in the overall 30-day mortality, being higher in colon surgery than in rectal surgery (11.5% vs 5.1%, p = 0.04). Conclusions: organ-space SSI in colon and rectal surgery has some differences in terms of incidence, risk factors and outcomes. These differences could be considered for surveillance purposes and for the implementation of preventive strategies. Administration of OAP would be an important measure to reduce the OS-SSI rate in both colon and rectal surgeries.BioMed Central2019201920172019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion8 p.application/pdfhttps://hdl.handle.net/2445/128585Articles publicats en revistes (Ciències Clíniques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1186/s13756-017-0198-8Antimicrobial Resistance and Infection Control, 2017, vol. 6, p. 40https://doi.org/10.1186/s13756-017-0198-8cc-by (c) Gomila, Aina et al., 2017http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1285852026-05-29T05:05:01Z
dc.title.none.fl_str_mv Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery
title Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery
spellingShingle Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery
Gomila Grange, Aina
Cirurgia colorectal
Infeccions quirúrgiques
Factors de risc en les malalties
Colorectal surgery
Surgical wound infection
Risk factors in diseases
title_short Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery
title_full Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery
title_fullStr Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery
title_full_unstemmed Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery
title_sort Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery
dc.creator.none.fl_str_mv Gomila Grange, Aina
Carratalà, Jordi
Camprubí Ferrer, Daniel
Shaw Perujo, Evelyn
Badia, Josep M.
Cruz, Antoni
Aguilar, Francesc
Nicolás, Carmen
Marron, Anna
Mora, Laura
Pérez, Rafel
Martín, Lydia
Vázquez, Rosa
López, Ana Felisa
Limón, Enrique
Gudiol i Munté, Francesc
Pujol Rojo, Miquel
author Gomila Grange, Aina
author_facet Gomila Grange, Aina
Carratalà, Jordi
Camprubí Ferrer, Daniel
Shaw Perujo, Evelyn
Badia, Josep M.
Cruz, Antoni
Aguilar, Francesc
Nicolás, Carmen
Marron, Anna
Mora, Laura
Pérez, Rafel
Martín, Lydia
Vázquez, Rosa
López, Ana Felisa
Limón, Enrique
Gudiol i Munté, Francesc
Pujol Rojo, Miquel
author_role author
author2 Carratalà, Jordi
Camprubí Ferrer, Daniel
Shaw Perujo, Evelyn
Badia, Josep M.
Cruz, Antoni
Aguilar, Francesc
Nicolás, Carmen
Marron, Anna
Mora, Laura
Pérez, Rafel
Martín, Lydia
Vázquez, Rosa
López, Ana Felisa
Limón, Enrique
Gudiol i Munté, Francesc
Pujol Rojo, Miquel
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cirurgia colorectal
Infeccions quirúrgiques
Factors de risc en les malalties
Colorectal surgery
Surgical wound infection
Risk factors in diseases
topic Cirurgia colorectal
Infeccions quirúrgiques
Factors de risc en les malalties
Colorectal surgery
Surgical wound infection
Risk factors in diseases
description Background: organ-space surgical site infections (SSI) are the most serious and costly infections after colorectal surgery. Most previous studies of risk factors for SSI have analysed colon and rectal procedures together. The aim of the study was to determine whether colon and rectal procedures have different risk factors and outcomes for organ-space SSI. Methods: a multicentre observational prospective cohort study of adults undergoing elective colon and rectal procedures at 10 Spanish hospitals from 2011 to 2014. Patients were followed up until 30 days post-surgery. Surgical site infection was defined according to the Centers for Disease Control and Prevention criteria. Oral antibiotic prophylaxis (OAP) was considered as the administration of oral antibiotics the day before surgery combined with systemic intravenous antibiotic prophylaxis. Results: of 3,701 patients, 2,518 (68%) underwent colon surgery and 1,183 (32%) rectal surgery. In colon surgery, the overall SSI rate was 16.4% and the organ-space SSI rate was 7.9%, while in rectal surgery the rates were 21.6% and 11.5% respectively (p < 0.001). Independent risk factors for organ-space SSI in colon surgery were male sex (Odds ratio -OR-: 1.57, 95% CI: 1.14-2.15) and ostomy creation (OR: 2.65, 95% CI: 1.8-3.92) while laparoscopy (OR: 0.5, 95% CI: 0.38-0.69) and OAP combined with intravenous antibiotic prophylaxis (OR: 0.7, 95% CI: 0.51-0.97) were protective factors. In rectal surgery, independent risk factors for organ-space SSI were male sex (OR: 2.11, 95% CI: 1.34-3.31) and longer surgery (OR: 1.49, 95% CI: 1.03-2.15), whereas OAP with intravenous antibiotic prophylaxis (OR: 0.49, 95% CI: 0.32-0.73) was a protective factor. Among patients with organ-space SSI, we found a significant difference in the overall 30-day mortality, being higher in colon surgery than in rectal surgery (11.5% vs 5.1%, p = 0.04). Conclusions: organ-space SSI in colon and rectal surgery has some differences in terms of incidence, risk factors and outcomes. These differences could be considered for surveillance purposes and for the implementation of preventive strategies. Administration of OAP would be an important measure to reduce the OS-SSI rate in both colon and rectal surgeries.
publishDate 2017
dc.date.none.fl_str_mv 2017
2019
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/128585
url https://hdl.handle.net/2445/128585
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s13756-017-0198-8
Antimicrobial Resistance and Infection Control, 2017, vol. 6, p. 40
https://doi.org/10.1186/s13756-017-0198-8
dc.rights.none.fl_str_mv cc-by (c) Gomila, Aina et al., 2017
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Gomila, Aina et al., 2017
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 8 p.
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Ciències Clíniques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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