Fukuda, H. Journal of Hospital Infection. Published online: 22 April 2016
Objective: To investigate 8 types of common gastrointestinal surgery in order to identify patient-related risk factors for surgical site infection (SSI) that could be collected as part of infection surveillance efforts.
Design: The study used record-linkage from existing datasets comprising the Japan Nosocomial Infections Surveillance (JANIS) and Diagnosis Procedure Combination (DPC) programs.
Methods: Patient data from 35 hospitals were retrieved using JANIS and DPC data from 2007 to 2011. Patient-related factors and the primary outcome of SSI occurrence were recorded and analyzed. Risk factors associated with SSI were examined using multilevel mixed-effects logistic regression models.
Results: A total of 2,074 appendectomies, 2,084 bile duct, liver, or pancreatic procedures, 3,460 cholecystectomies, 7,273 colonic, 482 oesophageal, 4,748 gastric, 2,762 rectal, and 1,202 small bowel procedures were analyzed. Using multivariate analyses, intraoperative blood transfusion was found to be a risk factor for SSI in all surgery types except appendectomy and small bowel surgery. In addition, diabetes was a risk factor for SSI in colon surgery (odds ratio [OR] = 1.23, P = 0.028) and gastric surgery (OR = 1.70, P < 0.001). Steroid use was statistically associated with a higher SSI incidence in cholecystectomy (OR = 2.92, P = 0.002) and colon surgery (OR = 1.33, P = 0.014).
Conclusions: Intraoperative blood transfusions, diabetes, and steroid use are risk factors in gastrointestinal surgical procedures, and should be included as part of an SSI surveillance for these procedures.
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