title: Risk factors for tissue and wound complications in gastrointestinal surgery.
abstract: BACKGROUND
  Surgical site infections and disruption of sutured tissue are frequent complications following surgery. We aimed to assess risk factors predictive of tissue and wound complications in open gastrointestinal surgery.
  
  
  METHODS
  Data from 4855 unselected patients undergoing open gastrointestinal surgery from 1995 through 1998 were recorded in a clinical database and validated. The database embraced variables related to patient history, preoperative clinical condition, operative findings and severity, and the surgeon's training. Variables predictive of surgical site infection and dehiscence of sutured tissue within 30 days after surgery were assessed by multiple logistic regression analysis.
  
  
  RESULTS
  Following elective operation, the incidence of tissue and wound complications was 6% compared with 16% in emergency surgery (P < 0.001). These complications resulted in prolonged hospitalization in 50% of the patients and a 3-fold higher risk of reoperation but not increased mortality. Factors associated with complications following elective operations were smoking, comorbidity, and perioperative blood loss. Following emergency operations, male gender, peritonitis, and multiple operations were predictors of complications. Irrespective of elective or emergency surgery, the type of operation was a predictor of complications.
  
  
  CONCLUSIONS
  Factors known to affect the process of tissue and wound healing are independently associated with tissue and wound complications following gastrointestinal surgery.
authors.affiliation: Department of Surgical Gastroenterology, Bispebjerg Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark. Its@dadlnet.dk
authors.forename: Lars Tue
authors.initials: LT
authors.lastname: Sørensen
authors.forename: Ulla
authors.initials: U
authors.lastname: Hemmingsen
authors.forename: Finn
authors.initials: F
authors.lastname: Kallehave
authors.forename: Peer
authors.initials: P
authors.lastname: Wille-Jørgensen
authors.forename: Johan
authors.initials: J
authors.lastname: Kjaergaard
authors.forename: Lisbeth Nørgaard
authors.initials: LN
authors.lastname: Møller
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D017558:Elective Surgical Procedures; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology*; D014945:Wound Healing / Q000502:physiology