Kiran et al evaluated risk factors for surgical site infections associated with colorectal surgery. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Cleveland Clinic.
Patient selection: colorectal surgery
Outcome: surgical site infection
Risk factors for surgical site infection from the multivariate analysis:
(1) age (odds ratio 0.97 for a 5-unit increase)
(2) ASA classification >= 3 (odds ratio 1.2)
(3) smoking (odds ratio 1.21)
(4) diabetes (odds ratio 1.25)
(5) operative time >= 180 minutes (odds ratio 1.42)
(6) appendicitis, diverticulitis or regional enteritis (odds ratio 1.30, 1.30 and 1.55)
(7) open procedure (laparoscopy protective, odds ratio 1.62)
(8) anastomosis involving the rectum (odds ratio 1.3)
(9) obesity (odds ratio was 1.16 for a 5-unit increase)
None of these risk factors have a particularly high odds ratio so multiple risk factors must be present to have a significant impact. The significance of age is difficult to judge so is not included in the implementation.
