Author, as appears in the article.: Gomila, A.; Carratala, J.; Biondo, S.; Badia, J. M.; Fraccalvieri, D.; Shaw, E.; Diaz-Brito, V.; Pagespetit, L.; Freixas, N.; Brugues, M.; Mora, L.; Perez, R.; Sanz, C.; Arroyo, N.; Iftimie, S.; Limon, E.; Gudiol, F.; Pujol, M.;VINCat Colon Surg Grp

Department: Medicina i Cirurgia

URV's Author/s: Iftimie Iftimie, Simona Mihaela

Keywords: Bowel preparation Colorectal cancer Colorectal surgery Healthcare-associated infection Impact Low anterior resection Nsqip Outcomes Program Rectal-cancer Risk-factors Stoma Surgical site infection Ventilator-associated pneumonia

Abstract: Background: Surgical site infections (SSIs) are the leading cause of healthcare-associated infections in acute care hospitals in Europe. However, the risk factors for the development of early-onset (EO) and late-onset (LO) SSI have not been elucidated.Aim: This study investigated the predictive factors for EO-SSI and LO-SSI in a large cohort of patients undergoing colorectal surgery.Methods: We prospectively followed-up adult patients undergoing elective colorectal surgery in 10 hospitals (2011-2014). Patients were divided into three groups: EO-SSI, LO-SSI, or no infection (no-SSI). The cut-off defining EO-SSI and LO-SSI was seven days (median time to SSI development). Different predictive factors for EO-SSI and LO-SSI were analysed, comparing each group with the no-SSI patients.Findings: Of 3701 patients, 320 (8.6%) and 349 (9.4%) developed EO-SSI and LO-SSI, respectively. The rest had no-SSI. Patients with EO-SSI were mostly males, had colon surgery and developed organ-space SSI whereas LO-SSI patients frequently received chemotherapy or radiotherapy and had incisional SSI. Male sex (odds ratio (OR): 1.92; P < 0.001), American Society of Anesthesiologists' physical status > 2 (OR: 1.51; P = 0.01), administration of mechanical bowel preparation (OR: 0.7; P = 0.03) and stoma creation (OR: 1.95; P < 0.001) predicted EO-SSI whereas rectal surgery (OR: 1.43; P = 0.03), prolonged surgery (OR: 1.4; P = 0.03) and previous chemotherapy (OR: 1.8; P = 0.03) predicted LO-SSI.Conclusion: We found distinctive predictive factors for the development of SSI before and after seven days following elective colorectal surgery. These factors could help establish specific preventive measures in each group. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Thematic Areas: Biodiversidade Biotecnología Ciências agrárias i Ciências biológicas i Ciências biológicas iii Educação física Enfermagem Engenharias iv Farmacia General medicine Infectious diseases Interdisciplinar Medicina i Medicina ii Medicina iii Medicine (miscellaneous) Microbiology (medical) Odontología Public, environmental & occupational health Química Saúde coletiva

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: simonamihaela.iftime@urv.cat simonamihaela.iftime@urv.cat

Author identifier: 0000-0003-0714-8414 0000-0003-0714-8414

Record's date: 2022-07-16

Papper version: info:eu-repo/semantics/acceptedVersion

Link to the original source: https://www.journalofhospitalinfection.com/article/S0195-6701(17)30695-3/fulltext#articleInformation

Papper original source: Journal Of Hospital Infection. 99 (1): 24-30

APA: Gomila, A.; Carratala, J.; Biondo, S.; Badia, J. M.; Fraccalvieri, D.; Shaw, E.; Diaz-Brito, V.; Pagespetit, L.; Freixas, N.; Brugues, M.; Mora, L.; P (2018). Predictive factors for early- and late-onset surgical site infections in patients undergoing elective colorectal surgery. A multicentre, prospective, cohort study. Journal Of Hospital Infection, 99(1), 24-30. DOI: 10.1016/j.jhin.2017.12.017

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Article's DOI: 10.1016/j.jhin.2017.12.017

Entity: Universitat Rovira i Virgili

Journal publication year: 2018

Publication Type: Journal Publications