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Risk Factors | Abdominal Surgery Infection

Purpose: To identify risk factors for postoperative wound infection following abdominal surgery based on the study of Neumayer et al.

Description

Neumayer et al used information from the Veterans Administration National Surgical Quality Improvement Program to identify risk factors for abdominal wound infection. These can help identify a patient who may benefit from steps to reduce the risk of surgical site infection. The authors are from the Veterans Administration Medical Center and the University of Utah in Salt Lake City, Utah.


Parameters:

(1) timing of surgery

(2) immunosuppression

(3) integrity of the gastrointestinal tract

(4) body weight

(5) diabetes mellitus

(6) alcohol, tobacco and/or drug abuse

(7) sepsis

(8) homeless status

(9) fluid in the abdomen

 

Parameter

Finding

Points

timing of the surgery

emergency

1

 

urgent or elective

0

immunosuppression

absent

0

 

present (cancer, corticosteroid therapy, organ transplant, other)

1

integrity of the GI tract

closed, intact

0

 

open

1

body weight

thin or normal

0

 

obese

1

diabetes mellitus

absent

0

 

present

1

alcohol, tobacco and/or drug abuse

absent

0

 

present

1

sepsis

absent

0

 

present

1

homeless

no

0

 

yes

1

fluid in abdomen

none or clear

0

 

pus, stool, blood

1

 

where:

• The reference to integrity of the GI tract probably refers to its preoperative status.

 

total risk score =

= SUM(points for all 9 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 9

• The higher the score the greater the risk for surgical site infection.

• A patient with a score >= 3 should have the wound left open, with either delayed primary closure or healing by secondary intent.


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Specialty

Objective

ICD-10