title: Hepatic steatosis is associated with surgical-site infection after hepatic and colorectal surgery.
abstract: BACKGROUND
  Obesity and increased visceral fat deposits are important risk factors for surgical-site infection (SSI). Interestingly, a potential role of hepatic steatosis on complications after extrahepatic surgery remains unknown. The aim of the present study was to investigate the impact of hepatic steatosis on SSI in patients that underwent open abdominal surgery.
  
  
  METHODS
  A total of 231 patients that underwent either liver (n = 116) or colorectal (n = 115) resection and received preoperative contrast-enhanced computed tomography scans were retrospectively investigated. Signal attenuation of the liver parenchyma was measured on computed tomography scans to assess hepatic steatosis.
  
  
  RESULTS
  More SSIs (including types 1, 2, and 3) were found in the group with hepatic steatosis (56/118 [47.5%]) compared with the control group (30/113 [26.6%]; P = .001). Patients with hepatic steatosis showed greater median body mass index than patients without hepatic steatosis (26.6 kg/m(2) [range 16.8-47.0 kg/m(2)] vs 23.2 kg/m(2) [15.9-32.7 kg/m(2)]; P < .001). Patients with hepatic steatosis experienced longer median operation times (297 minutes [52-708 minutes] vs 240 minutes [80-600 minutes]; P = .003). In a multivariate analysis, hepatic steatosis was identified as an independent risk factor for SSI in patients undergoing hepatic (odds ratio 10.33 [95% confidence interval 1.19-89.76]; P = .03) or colorectal (odds ratio 6.67 [95% confidence interval 1.12-39.33]; P = .04) operation.
  
  
  CONCLUSIONS
  Hepatic steatosis is associated with SSI after hepatic and colorectal operation.
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, Bern, Switzerland.
authors.forename: Anita
authors.initials: A
authors.lastname: Kurmann
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, Bern, Switzerland.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Wanner
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, Bern, Switzerland.
authors.forename: Florian
authors.initials: F
authors.lastname: Martens
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, Bern, Switzerland.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Klasen
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, Bern, Switzerland.
authors.forename: Felix
authors.initials: F
authors.lastname: Stickel
authors.affiliation: Institute of Pathology, University of Bern, Bern, Switzerland.
authors.forename: Matteo
authors.initials: M
authors.lastname: Montani
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Candinas
authors.affiliation: Department of Visceral Surgery and Medicine, Inselspital University Hospital Bern and University Bern, Bern, Switzerland. Electronic address: Guido.Beldi@insel.ch.
authors.forename: Guido
authors.initials: G
authors.lastname: Beldi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003082:Colectomy; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011300:Preoperative Care; D057234:Preoperative Period; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed