• Annals of surgery · Jan 2012

    Development and validation of a novel stratification tool for identifying cancer patients at increased risk of surgical site infection.

    • Daniel A Anaya, Janice N Cormier, Yan Xing, Paul Koller, Lindsay Gaido, Donna Hadfield, Roy F Chemaly, and Barry W Feig.
    • Michael E. DeBakey Department of Surgery-Surgical Oncology, Houston, TX, USA. danaya@bcm.edu
    • Ann. Surg. 2012 Jan 1; 255 (1): 134-9.

    ObjectiveTo identify cancer-specific predictors of postoperative surgical site infection (SSI), and to develop a risk-stratification prognostic tool and compare its performance with traditional measures.BackgroundThe incidence and risk factors for SSI in cancer patients are unknown; current risk-stratification tools are not cancer-specific.MethodsA prospective cohort study of patients undergoing elective operations (n = 503) at a tertiary cancer center was conducted. SSI was assessed using postdischarge active surveillance. Multivariate logistic regression analyses were performed to identify predictors of SSI, and β-coefficients were used to create a scoring system. The sum of these was used to create a Risk of Surgical Site Infection in Cancer (RSSIC) score. The RSSIC was validated using bootstrapping techniques, and its discrimination was compared with the National Nosocomial Infection Surveillance (NNIS) risk index.ResultsThe 30-day SSI incidence was 24%. Significant predictors of SSI included preoperative chemotherapy (OR = 1.94 [95% CI, 1.16-3.25]), clean-contaminated wounds (OR = 2.1 [95% CI, 1.24-3.55]), operative time ≥2 hours (OR = 1.75 [95% CI, 1.01-3.04]) and ≥4 hours (OR = 2.24 [95% CI, 1.22-4.1]), and surgical site: groin (OR = 4.65 [95% CI, 1.69-12.83]), and head/neck (OR = 0.12 [95% CI, 0.02-0.89]). The RSSIC score stratified patients into 4 risk strata for SSI. The performance of this score exceeded that of the NNIS score (AUC = 0.70 vs. 0.63, respectively; P = 0.01).ConclusionSSIs are common following cancer surgery. Preoperative chemotherapy, in addition to other common risk factors, was identified as a significant predictor for SSI in cancer patients. The RSSIC improves risk-stratification of cancer patients and identifies those that may benefit from more aggressive or novel preventive strategies.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…