title: Timing of postoperative infections after colectomy: evidence from NSQIP.
abstract: BACKGROUND
  We studied whether risk factors for infectious complications differed between inpatient (IP) and postdischarge (PD) periods in patients undergoing colon surgery.
  
  
  METHODS
  Among partial colon resection patients in the National Surgical Quality Improvement Program (2005 to 2010), we identified risk factors for superficial and deep (D-SSI) surgical site infections and urinary tract infections in the IP and PD phases of care.
  
  
  RESULTS
  Obesity was associated with higher risk of both IP superficial surgical site infections and D-SSI (odds ratio [OR] 1.41, P < .0001 and OR 1.28, P < .0001) and increasing to OR 1.73 (P < .0001) and OR 1.83 (P < .0001), respectively, in the PD period. Smoking was associated with development of D-SSI, and this risk increased from IP to PD phases of care (OR 1.15, P = .02 to OR 1.54, P < .0001).
  
  
  CONCLUSIONS
  Risk factors for infections differ between IP and PD phases of care in colon surgery patients. Earlier discharge from the hospital may shift recognition of an SSI to the outpatient setting.
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: Matthew Z
authors.initials: MZ
authors.lastname: Wilson
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: Peter W
authors.initials: PW
authors.lastname: Dillon
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Stewart
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: chollenbeak@hmc.psu.edu.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods*; D016001:Confidence Intervals; D019317:Evidence-Based Medicine; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology*; D015996:Survival Rate; D013997:Time Factors
keywords: Colectomy; Outcomes; Risk factors; Surgical site infection