title: Risk factors associated with surgical site infection after ileal pouch-anal anastomosis in ulcerative colitis.
abstract: OBJECTIVE
  Surgery for inflammatory bowel disease is known to be have an increased risk of morbidity. Few studies have investigated the risk factors for surgical site infection in patients undergoing surgery for inflammatory bowel disease restricted to ulcerative colitis, and no known precise evaluation of risk factors has been presented because of the many differences and confounding factors, such as disease specificities, surgical procedures, and patient characteristics. We evaluated the influences of patient conditions on the occurrence of surgical site infection after an ileal J-pouch-anal anastomosis for ulcerative colitis.
  
  
  METHODS
  Surgical site infections in 192 patients with ulcerative colitis who underwent surgery at Hyogo College of Medicine between March 2006 and April 2008 were investigated. Possible risk factors for surgical site infection were analyzed by univariate and multivariate logistic regression analyses to determine the predictive significance of those factors.
  
  
  RESULTS
  The incidence of incisional surgical site infection was 12.5%, and the incidence of organ/space surgical site infection was 1.6%. In a stepwise logistic regression model, total prednisolone >or=10,000 mg (odds ratio, 3.33; 95% CI 1.03-10.73;P = .04) and American Society of Anesthesiologists' score >or=3 (odds ratio, 3.45; 95% CI 1.12-10.62; P = .03) were shown to be independent risk factors for incisional surgical site infection, whereas no risk factors were found for overall surgical site infection.
  
  
  CONCLUSIONS
  Our results indicate that a higher total steroid dose is related to incisional surgical site infection with fewer confounding factors in patients with ulcerative colitis. In addition, total prednisolone >or=10,000 mg may be an additional factor for surgical indication in these patients.
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. motoi.uchino@nifty.ne.jp
authors.forename: Motoi
authors.initials: M
authors.lastname: Uchino
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeuchi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Toshie
authors.initials: T
authors.lastname: Tsuchida
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takesue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*; D055815:Young Adult