The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study

(1) Background: Healthcare-associated infections (HAIs) after head and neck free-flap reconstruction are a common postoperative complication. Risk factors for HAIs in this context and their consequences have not been adequately described. (2) Methods: Ongoing prospective multicentre study between 02...

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Autores: Ramos Zayas, Ana, López Medrano, Francisco, Urquiza Fornovi, Irene, Zubillaga Rodríguez, Ignacio, Gutiérrez, Ramón, Sánchez Aniceto, Gregorio, Acero, Julio, Almeida, Fernando, Galdona, Ana, Morán, María José, Pampin, Marta, Cebrián, José Luis
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/6888
Acceso en línea:https://hdl.handle.net/20.500.14352/6888
Access Level:acceso abierto
Palabra clave:head and neck surgery
reconstructive surgery
free flaps
healthcare-associated infections
surgical site infection
antibiotic prophylaxis
resistant microorganisms
osteoradionecrosis
Inmunología
Oncología
2412 Inmunología
3201.01 Oncología
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spelling The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre StudyRamos Zayas, AnaLópez Medrano, FranciscoUrquiza Fornovi, IreneZubillaga Rodríguez, IgnacioGutiérrez, RamónSánchez Aniceto, GregorioAcero, JulioAlmeida, FernandoGaldona, AnaMorán, María JoséPampin, MartaCebrián, José Luishead and neck surgeryreconstructive surgeryfree flapshealthcare-associated infectionssurgical site infectionantibiotic prophylaxisresistant microorganismsosteoradionecrosisInmunologíaOncología2412 Inmunología3201.01 Oncología(1) Background: Healthcare-associated infections (HAIs) after head and neck free-flap reconstruction are a common postoperative complication. Risk factors for HAIs in this context and their consequences have not been adequately described. (2) Methods: Ongoing prospective multicentre study between 02/2019 and 12/2020. Demographic characteristics and outcomes were analysed, focusing on infections. (3) Results: Forty out of 65 patients (61.54%) suffered HAIs (surgical site infection: 52.18%, nosocomial pneumonia: 23.20%, bloodstream infection: 13% and urinary tract infection: 5.80%). Methicillin-resistant Staphylococcus aureus (MRSA) and resistant Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae were the most frequently implicated. The significant risk factors for infection were: previous radiotherapy (Odds ratio (OR): 5.42; 95% confidence interval (CI), 1.39–21.10), anaemia (OR: 8.00; 95% CI, 0.96–66.95), salvage surgery (eight out of eight patients), tracheostomy (OR: 2.86; 95% CI, 1.01–8.14), surgery duration (OR: 1.01; 95% CI, 1.00–1.02), microvascular reoperation <72 h (eight/eight) and flap loss (eight/eight). The major surgical complications were: a need to reoperate (OR: 6.89; 95% CI, 1.42–33.51), prolonged hospital admission (OR: 1.16; 95% CI, 1.06–1.27) and delay in the initiation of postoperative radiotherapy (OR: 9.07; 95% CI, 1.72–47.67). The sixth month mortality rate in patients with HAIs was 7.69% vs. 0% in patients without HAIs (p = 0.50). (4) Conclusions: HAIs were common after this type of surgery, many of them caused by resistant microorganisms. Some modifiable risk factors were identified. Infections played a role in cancer prognosis by delaying adjuvant therapy.MPDIUniversidad Complutense de Madrid20212021-04-2720212021-04-27journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/6888reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución 3.0 Españahttps://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/68882026-06-02T12:44:21Z
dc.title.none.fl_str_mv The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
title The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
spellingShingle The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
Ramos Zayas, Ana
head and neck surgery
reconstructive surgery
free flaps
healthcare-associated infections
surgical site infection
antibiotic prophylaxis
resistant microorganisms
osteoradionecrosis
Inmunología
Oncología
2412 Inmunología
3201.01 Oncología
title_short The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
title_full The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
title_fullStr The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
title_full_unstemmed The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
title_sort The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study
dc.creator.none.fl_str_mv Ramos Zayas, Ana
López Medrano, Francisco
Urquiza Fornovi, Irene
Zubillaga Rodríguez, Ignacio
Gutiérrez, Ramón
Sánchez Aniceto, Gregorio
Acero, Julio
Almeida, Fernando
Galdona, Ana
Morán, María José
Pampin, Marta
Cebrián, José Luis
author Ramos Zayas, Ana
author_facet Ramos Zayas, Ana
López Medrano, Francisco
Urquiza Fornovi, Irene
Zubillaga Rodríguez, Ignacio
Gutiérrez, Ramón
Sánchez Aniceto, Gregorio
Acero, Julio
Almeida, Fernando
Galdona, Ana
Morán, María José
Pampin, Marta
Cebrián, José Luis
author_role author
author2 López Medrano, Francisco
Urquiza Fornovi, Irene
Zubillaga Rodríguez, Ignacio
Gutiérrez, Ramón
Sánchez Aniceto, Gregorio
Acero, Julio
Almeida, Fernando
Galdona, Ana
Morán, María José
Pampin, Marta
Cebrián, José Luis
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv head and neck surgery
reconstructive surgery
free flaps
healthcare-associated infections
surgical site infection
antibiotic prophylaxis
resistant microorganisms
osteoradionecrosis
Inmunología
Oncología
2412 Inmunología
3201.01 Oncología
topic head and neck surgery
reconstructive surgery
free flaps
healthcare-associated infections
surgical site infection
antibiotic prophylaxis
resistant microorganisms
osteoradionecrosis
Inmunología
Oncología
2412 Inmunología
3201.01 Oncología
description (1) Background: Healthcare-associated infections (HAIs) after head and neck free-flap reconstruction are a common postoperative complication. Risk factors for HAIs in this context and their consequences have not been adequately described. (2) Methods: Ongoing prospective multicentre study between 02/2019 and 12/2020. Demographic characteristics and outcomes were analysed, focusing on infections. (3) Results: Forty out of 65 patients (61.54%) suffered HAIs (surgical site infection: 52.18%, nosocomial pneumonia: 23.20%, bloodstream infection: 13% and urinary tract infection: 5.80%). Methicillin-resistant Staphylococcus aureus (MRSA) and resistant Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae were the most frequently implicated. The significant risk factors for infection were: previous radiotherapy (Odds ratio (OR): 5.42; 95% confidence interval (CI), 1.39–21.10), anaemia (OR: 8.00; 95% CI, 0.96–66.95), salvage surgery (eight out of eight patients), tracheostomy (OR: 2.86; 95% CI, 1.01–8.14), surgery duration (OR: 1.01; 95% CI, 1.00–1.02), microvascular reoperation <72 h (eight/eight) and flap loss (eight/eight). The major surgical complications were: a need to reoperate (OR: 6.89; 95% CI, 1.42–33.51), prolonged hospital admission (OR: 1.16; 95% CI, 1.06–1.27) and delay in the initiation of postoperative radiotherapy (OR: 9.07; 95% CI, 1.72–47.67). The sixth month mortality rate in patients with HAIs was 7.69% vs. 0% in patients without HAIs (p = 0.50). (4) Conclusions: HAIs were common after this type of surgery, many of them caused by resistant microorganisms. Some modifiable risk factors were identified. Infections played a role in cancer prognosis by delaying adjuvant therapy.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-04-27
2021
2021-04-27
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/6888
url https://hdl.handle.net/20.500.14352/6888
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 3.0 España
https://creativecommons.org/licenses/by/3.0/es/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 3.0 España
https://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MPDI
publisher.none.fl_str_mv MPDI
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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