Surgical site infections after colorectal surgery: do risk factors vary depending on the type of infection considered?
BACKGROUND
The purpose of this study was to compare risk factors for the development of incisional versus organ/space infections in patients undergoing colorectal surgery.


METHODS
An institutional review board-approved retrospective review was performed examining a 4-year period (January 2002 to December 2005). Patients were included if they had undergone abdominal operations (open or laparoscopic) in which the colon/rectum was surgically manipulated. Patients were excluded if the surgical wound was not closed primarily. A standardized definition of incisional and organ/space infection was employed.


RESULTS
A total of 428 operations were performed. Overall, 105 infections were identified (25%); 73 involved the incision and 32 were classified as organ/space. Multivariate analysis suggested that incisional infection was independently associated with body mass index (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.02-1.11) and creation/revision/reversal of an ostomy (OR, 2.2; 95% CI, 1.3-3.9). Organ/space infection was independently associated with perioperative transfusion (OR, 2.3; 95% CI, 1.1-5.5) and with previous abdominal surgery (OR, 2.5; 95% CI, 1.2-5.3).


CONCLUSIONS
Factors associated with infection differed based on the type of surgical site infection being considered. The lack of overlap between factors associated with incisional infection and organ/space infection suggests that separate risk models and treatment strategies should be developed.
Blumetti
Jennifer
J
Department of Surgery, University of Texas, Southwestern Medical Center, Dallas, TX, USA.
Luu
Myda
M
Sarosi
George
G
Hartless
Kathleen
K
McFarlin
Jackie
J
Parker
Betty
B
Dineen
Sean
S
Huerta
Sergio
S
Asolati
Massimo
M
Varela
Esteban
E
Anthony
Thomas
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data; D015992:Body Mass Index; D003106:Colon / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D010030:Ostomy / Q000706:statistics & numerical data*; D012007:Rectum / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*