A Risk Model for Surgical Site Infection in the Gastric Cancer Surgery Using Data of 790 Patients.
BACKGROUND
Understanding risk factors of surgical site infections (SSIs) in gastrectomy is important to provide the best treatment for the patients with gastric cancer.


METHODS
This is a retrospective observational study using the medical records of 790 patients with gastrectomy from 2005 through 2009. SSIs were classified into incisional SSIs (iSSIs) and organ/space SSIs (o/sSSIs).


RESULTS
iSSIs and o/sSSIs were detected in 41 (5.2%) patients and 68 (8.6%) patients, respectively. Open surgery was the only independent risk factor (p = 0.028) for iSSIs, while open surgery (p = 0.004), concurrent splenectomy (p < 0.001), operative time ≥220 min (p = 0.009), preoperative body mass index ≥20.8 kg/m2 (p = 0.004) and male gender (p = 0.028) were the independent risk factors for o/sSSIs. We created a risk model for o/sSSIs using these independent risk factors. The C-index model discrimination was 0.84 (p < 0.001), and the calibration of the models demonstrated a linear correlation between the predicted and observed probability.


CONCLUSIONS
We reported the risk factors of SSIs for gastrectomy. The risk model developed in this study for o/sSSIs pertaining to gastric cancer surgery would contribute to provide guidance for the development of best practices.
Department of Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan.
Hideki
H
Ushiku
Kei
K
Hosoda
Keishi
K
Yamashita
Natsuya
N
Katada
Shiro
S
Kikuchi
Harukazu
H
Tsuruta
Masahiko
M
Watanabe
D000368:Aged; D019540:Area Under Curve; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013156:Splenectomy / Q000009:adverse effects; D013274:Stomach Neoplasms / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology*