Risk Factors of Pessaux et al for Surgical Site and Global Infection in Patients After Noncolorectal Abdominal Surgery

 

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)