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Surgical Site Infection Risk Factors Following Elective Resection of Colon and/or Rectum

Purpose: To predict the cumulative odds ratio for a surgical site infection (SSI) for a patient undergoing elective colorectal resection as reported by Tang et al.

Description

Tang et al identified risk factors for surgical site infection following elective resection of the colorectum. These can help to identify a patient who may require closer monitoring for complications. The authors are from Chang Gung Memorial Hospital in Linkou, Taiwan.


Patient selection: elective surgery

 

Parameters:

(1) ASA score

(2) gender

(3) type of operation

(4) surgeon

(5) ostomy creation

(6) wound contamination

(7) use of a drain

(8) blood transfusion during and after surgery

 

Parameter

Finding

OR

ASA score

1

1

 

2 or 3

1.7

gender

female

1

 

male

1.5

surgeon

low risk

1

 

intermediate risk

2.4

 

high risk

3.7

type of operation

abdominoperitoneal resection

1

 

anterior resection

4.8

 

segmental colectomy

4.4

 

total or subtotal colectomy

9.5

 

Harmann's operation

2.2

ostomy

not created

1

 

created

2.1

wound

not contaminated

1

 

contaminated

2.8

drain

not used

1

 

used

1.6

blood transfusion

none

1

 

1 to 3 units

2.0

 

4 or more

6.2

 

where:

• A patient with an ASA score of 4 or 5 is unlikely to undergo an elective resection.

• The OR for surgeons is a simplification. The authors calculated an OR for each surgeon.

• The OR are from Table 3 page 186. Some of the numbers in the abstract are different.

 

cumulative odds ratio for SSI =

= PRODUCT(OR for all 8 risk factors)

 

Interpretation:

• minimum cumulative OR: 1

• maximum cumulative OR: over 5,000

 

Additional risk factors:

(1) operative time > 3 hours (for incisional SSI)

(2) failure to use prophylactic antibiotics

(3) hypoalbuminemia (for incisional SSI)


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Specialty

Objective

ICD-10