title: Epidemiology and risk factors associated with surgical site infection after different types of hepatobiliary and pancreatic surgery.
abstract: OBJECTIVE
  Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs); however, SSI after hepatobiliary and pancreatic surgery (HBPS) has not been well investigated in a large cohort of patients. This study analyzed the factors associated with SSI following HBPS in Japan, using a Japanese national database.
  
  
  METHODS
  Data on HBPS performed between 2012 and 2014 were extracted from a national monitoring system for HAI: The Japan Nosocomial Infections Surveillance. Using multivariate logistic regression, I assessed the factors associated with SSI.
  
  
  RESULTS
  The cumulative incidence of SSI following HBPS was 15.6% (2873/18,398). The incidence of SSI after pancreatoduodenectomy was 28.0%, which was significantly higher than that after liver resection and other types of HBPS (8.8 and 15.5%, respectively). Among the four traditional risk factors, the American Society of Anesthesiologists score was ineffective for predicting SSI in the final model of all three types of surgery. Additional risk factors were identified, including age and male gender.
  
  
  CONCLUSIONS
  The incidence of and factors associated with SSI after the three types of HBPS analyzed differed significantly. To accurately compare hospital performance in relation to SSI following HBPS, the operative procedure category in the surveillance system must be divided into three types.
authors.affiliation: Division of Infection Control and Clinical Laboratory, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan. morikane-tky@umin.net.
authors.forename: Keita
authors.initials: K
authors.lastname: Morikane
mesh_terms: D000368:Aged; D001662:Biliary Tract Surgical Procedures; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology*
keywords: Hepatobiliary and pancreatic surgery; Operative procedure category; Risk factor; Surgical site infection