Factors influencing the risk of surgical site infection following diagnostic exploration of the abdominal cavity.
OBJECTIVE
We assessed the contribution of the surgical approach and the NNIS system's surgical component variables to surgical site infection (SSI) risk after diagnostic exploration of the abdominal cavity.


METHODS
Retrospective cohort study with prospective data collection (1993-2006) in five private, non-universitary, secondary or tertiary healthcare facilities. Outcome variable was SSI development within 30 days after surgery. Explanatory variables were age, gender, surgical approach (laparoscopic/open), elective/emergency/trauma procedure, hospital, surgeon, year, additional procedures, wound class, operation duration and ASA-PS score.


RESULTS
Consecutive in-patients (6761) were included. Mean age was 38.1 (+/-14.1) years and 87.3% were female; 68% procedures were laparoscopic. Postdischarge follow-up was obtained for 57.7% patients. Patients operated on laparoscopically had reduced adjusted overall risk of SSI (OR=0.40, 95% CI=0.28-0.56), incisional infection (OR=0.43, 95% CI=0.29-0.62) and organ/space infection (OR=0.19, 95% CI=0.07-0.49). Older age, longer procedures, emergency or trauma procedures, medium- or high-risk surgeons and year <or=1999 increased the adjusted risk of incisional infection. Adjusted risk of organ/space infection was higher in older patients, emergency or trauma procedures, additional procedures and procedures performed by high-risk surgeons.


CONCLUSIONS
Laparoscopy was associated with lower risk of incisional and organ/space infection. NNIS system's surgical component variables contributed variably to SSI risk.
Biscione
Fernando M
FM
Health Sciences Postgraduate Course, Medicine High School, Minas Gerais Federal University, 190 Alfredo Balena Avenue, Room 7003, Santa Efigênia, Belo Horizonte, Minas Gerais 31.130-100, Brazil. fernandobiscione@yahoo.com.ar
Couto
Renato C
RC
Pedrosa
Tânia M
TM
Neto
Mozar C
MC
D034841:Abdominal Cavity / Q000601:surgery; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D016896:Treatment Outcome