Pesseaux et al evaluated risk factors associated with infection following abdominal operations not involving the colon or rectum. This can help identify those patients who may require closer monitoring or more aggressive management. The authors are from multiple hospitals in France and are members of the French Association for Surgical Research.
Risk factors for surgical site infection:
(1) preoperative cutaneous abscess or cutaneous necrosis
(2) suture placed in digestive tract or bowel anastomosis
(3) postoperative drainage
(4) surgery for treatment of cancer
(5) receiving curative (non-prophylactic) anticoagulant therapy postoperatively
Risk Factor |
Odds Ratio |
95% CI |
p value |
cutaneous abscess or necrosis |
4.75 |
1.08 to 20.92 |
|
suture or anastomosis in bowel |
1.82 |
1.04 to 3.20 |
|
postoperative drainage |
2.15 |
1.30 to 3.57 |
|
cancer surgery |
1.74 |
1.07 to 2.82 |
|
curative anticoagulant therapy postop |
3.33 |
1.47 to 7.56 |
|
from Table 4, page 321
Risk factors for global infection (surgical site infection, urinary tract infections, sepsis, catheter-related infections, other):
(1) age >= 60 years
(2) underweight preoperative (usually reflecting malnourishment)
(3) cirrhosis
(4) vertical abdominal incision
(5) suture placed in digestive tract or bowel anastomosis
(6) operative time > 60 minutes
(7) operation class 4 surgical site (dirty/contaminated)
Protective factors:
(1) ceftriaxone therapy (as compared to cefazolin)
Risk Factor |
Odds Ratio |
95% CI |
p value |
age |
1.64 if 60-74; 1.45 if >= 75 |
1.24 to 2.17; 1.00 – 2.09 |
|
underweight |
1.51 |
1.08 to 2.10 |
|
cirrhosis |
2.45 |
1.37 to 4.38 |
|
vertical incision |
1.66 |
1.10 to 2.49 |
|
suture or anastomosis in bowel |
1.48 |
1.04 to 2.09 |
|
operative time |
1.66 if 61-120 minutes; 2.72 if > 120 minutes |
1.05 to 2.04; 1.9 to 3.91) |
|
class 4 operation |
1.66 |
1.04 to 2.64 |
|
ceftriaxone |
0.43 |
0.29 to 0.64 |
|
from Table 5, page 322
Risk factors for parietal infectious complications (wound infection, cellulitis; gangrene; Table 4):
(1) obesity
(2) parietal drainage
(3) cancer surgery
(4) receiving curative (non-prophylactic) anticoagulant therapy postoperatively
Risk factors for deep infection with fistula (Table 4):
(1) underweight preoperative
(2) abscess or necrosis of skin preoperative
(3) abdominal drainage
Risk factors for deep infection without fistula (Table 4):
(1) abscess or necrosis of skin preoperative
(2) iodized alcohol as skin preparation
(3) receiving curative (non-prophylactic) anticoagulant therapy postoperatively
Risk factors for urinary infections (Table 4):
(1) age >= 60
(2) surgical incision oblique outside and low
(3) urinary catheterization post-operative
Risk factors for catheter infections:
(1) age >= 60 years
(2) ascites
(3) abdominal drainage
Protective factors for all of the above infections:
(1) antibiotic prophylaxis (cefotaxime, ceftriaxone or amoxicillin + clavulanate)
(2) abdominal drainage (for deep infection without fistula)
Specialty: Infectious Diseases
ICD-10: ,