title: Crohn's disease but not diverticulitis is an independent risk factor for surgical site infections in colectomy.
abstract: BACKGROUND
  Surgical site infections (SSIs) after colectomy for colon cancer (CC), Crohn's disease (CD), and diverticulitis (DD) significantly impact both the immediate postoperative course and long-term disease-specific outcomes. We aim to profile the effect of diagnosis on SSI after segmental colectomy using the National Surgical Quality Improvement Program (NSQIP) data set.
  
  
  METHODS
  NSQIP data from 2006 to 2011 were investigated, and segmental colectomy procedures performed for the diagnoses of Crohn's disease, DD, and colon malignancy were included. SSI complications were compared by diagnosis using univariate and multivariate analysis.
  
  
  RESULTS
  We included 35,557 colectomy cases in the analysis. CD had the highest rate of postoperative SSI (17 vs. 13% DD vs. 10% CC; p < 0.001). Using CC as the comparison group and controlling for multiple variables, the multivariate analysis showed that the CD group had an increased risk for acquiring at least one SSI (odds ratio (OR) = 1.38, p ≤ 0.001), deep incisional SSI (OR = 1.85, p = 0.03), and organ space SSI (OR = 1.51, p = 0.02).
  
  
  CONCLUSIONS
  For patients undergoing segmental colectomy in the NSQIP data set, statistically significant increases in SSI are seen in CD, but not DD, when compared to CC, thus confirming CD as an independent risk factor for SSI.
authors.affiliation: Department of Surgery, Division of Gastrointestinal, Minimally Invasive, and Bariatric Surgery, The University of Iowa Carver College of Medicine, 200 Hawkins Drive, 4577 JCP, Iowa City, IA, 52242, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Wideroff
authors.forename: Yunfan
authors.initials: Y
authors.lastname: Xing
authors.forename: Junlin
authors.initials: J
authors.lastname: Liao
authors.forename: John C
authors.initials: JC
authors.lastname: Byrn
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007484:Iowa / Q000453:epidemiology; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*
references.citation: Am J Infect Control. 1992 Oct;20(5):271-4
references.pmid: 1332552
references.citation: Dis Colon Rectum. 2014 Jun;57(6):733-9
references.pmid: 24807598
references.citation: J Am Coll Surg. 2012 Apr;214(4):574-80; discussion 580-1
references.pmid: 22321525
references.citation: J Gastrointest Surg. 2011 Aug;15(8):1354-60
references.pmid: 21626229
references.citation: Am J Infect Control. 1996 Oct;24(5):380-8
references.pmid: 8902113
references.citation: Emerg Infect Dis. 2003 Feb;9(2):196-203
references.pmid: 12603990
references.citation: J Am Coll Surg. 2010 Aug;211(2):232-8
references.pmid: 20670861
references.citation: Infect Control Hosp Epidemiol. 1999 Apr;20(4):250-78; quiz 279-80
references.pmid: 10219875
references.citation: Dis Colon Rectum. 2000 Jan;43(1):83-91
references.pmid: 10813129
references.citation: Ann Surg. 2004 May;239(5):599-605; discussion 605-7
references.pmid: 15082963
references.citation: Ann Surg. 2006 Nov;244(5):758-63
references.pmid: 17060769
references.citation: Infect Control Hosp Epidemiol. 1999 Nov;20(11):725-30
references.pmid: 10580621
references.citation: Dis Colon Rectum. 2009 Jun;52(6):1054-63; discussion 1064
references.pmid: 19581846
references.citation: Surg Infect (Larchmt). 2006;7 Suppl 2:S41-3
references.pmid: 16895503
references.citation: Ann Surg. 2013 Dec;258(6):847-53
references.pmid: 24169157
references.citation: JAMA Surg. 2013 Apr;148(4):316-21
references.pmid: 23715829
references.citation: Qual Manag Health Care. 2007 Jul-Sep;16(3):219-25
references.pmid: 17627217
references.citation: J Am Coll Surg. 2011 Dec;213(6):784-92
references.pmid: 21945417
references.citation: Ann Surg. 2001 Aug;234(2):181-9
references.pmid: 11505063