TY - JOUR
T1 - Epidemiology and outcomes associated with surgical site infection following bariatric surgery
AU - Chopra, Teena
AU - Marchaim, Dror
AU - Lynch, Ylinne
AU - Kosmidis, Chris
AU - Zhao, Jing J
AU - Dhar, Sorabh
AU - Gheyara, Naasha
AU - Turner, Deborah
AU - Gulish, Don
AU - Wood, Michael
AU - Alangaden, George
AU - Kaye, Keith S
N1 - Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
PY - 2012/11
Y1 - 2012/11
N2 - BACKGROUND: Surgical site infection (SSI) is a frequent problem complicating bariatric surgery. However, the potential risk factors, risk stratification, and outcomes of SSIs in this patient population remain poorly defined. The aim of this prospective case-control study was to characterize better the risk factors and to improve risk stratification for SSIs following bariatric surgery.METHODS: Patients studied had SSI following Roux-en-Y gastric bypass surgery (RYGBS) between November 2006 and March 2009 at Harper University Hospital and were each matched with 3 controls based on type of operative procedure, surgeon, and year of surgery. Thirty-day outcomes included mortality, hospital readmissions, outpatient procedures, and emergency room visits. A scoring system (BULCS score) was compared with the National Nosocomial Infections Surveillance system risk index using logistic regression.RESULTS: In multivariate analysis, duration of surgery (odds ratio [OR], 3.3; 95% confidence interval [CI]: 1.62-6.74), diagnosis of bipolar disorder (OR, 3.341; 95% CI: 1.0-12.27), use of prophylactic antibiotics other than cefazolin (OR, 4.2; 95% CI: 1.47-11.69), and sleep apnea (OR, 1.8; 95% CI: 1.05-2.97) were significantly associated with SSI. Patients with SSI were more likely to have return emergency visits (OR, 4.96; 95% CI: 2.9-8.48), readmission (OR, 6.53; 95% CI: 3.44-12.42), and outpatient procedures following surgery (OR, 4.75; 95% CI: 1.32-17.14) than were controls without SSI. The BULCS score was a stronger predictor of SSI than the National Nosocomial Infections Surveillance system (C-statistic, -0.62 vs 0.55, respectively).CONCLUSION: SSI following bariatric surgery was associated with receipt of antibiotic prophylaxis other than cefazolin and comorbid conditions including sleep apnea and bipolar disorder. The BULCS score performed favorably as a predictor and risk adjuster for SSI following bariatric surgery. SSI was associated with increased health care resource utilization.
AB - BACKGROUND: Surgical site infection (SSI) is a frequent problem complicating bariatric surgery. However, the potential risk factors, risk stratification, and outcomes of SSIs in this patient population remain poorly defined. The aim of this prospective case-control study was to characterize better the risk factors and to improve risk stratification for SSIs following bariatric surgery.METHODS: Patients studied had SSI following Roux-en-Y gastric bypass surgery (RYGBS) between November 2006 and March 2009 at Harper University Hospital and were each matched with 3 controls based on type of operative procedure, surgeon, and year of surgery. Thirty-day outcomes included mortality, hospital readmissions, outpatient procedures, and emergency room visits. A scoring system (BULCS score) was compared with the National Nosocomial Infections Surveillance system risk index using logistic regression.RESULTS: In multivariate analysis, duration of surgery (odds ratio [OR], 3.3; 95% confidence interval [CI]: 1.62-6.74), diagnosis of bipolar disorder (OR, 3.341; 95% CI: 1.0-12.27), use of prophylactic antibiotics other than cefazolin (OR, 4.2; 95% CI: 1.47-11.69), and sleep apnea (OR, 1.8; 95% CI: 1.05-2.97) were significantly associated with SSI. Patients with SSI were more likely to have return emergency visits (OR, 4.96; 95% CI: 2.9-8.48), readmission (OR, 6.53; 95% CI: 3.44-12.42), and outpatient procedures following surgery (OR, 4.75; 95% CI: 1.32-17.14) than were controls without SSI. The BULCS score was a stronger predictor of SSI than the National Nosocomial Infections Surveillance system (C-statistic, -0.62 vs 0.55, respectively).CONCLUSION: SSI following bariatric surgery was associated with receipt of antibiotic prophylaxis other than cefazolin and comorbid conditions including sleep apnea and bipolar disorder. The BULCS score performed favorably as a predictor and risk adjuster for SSI following bariatric surgery. SSI was associated with increased health care resource utilization.
KW - Adult
KW - Ambulatory Care/statistics & numerical data
KW - Anti-Bacterial Agents/therapeutic use
KW - Antibiotic Prophylaxis/methods
KW - Bariatric Surgery/adverse effects
KW - Case-Control Studies
KW - Emergency Medical Services/statistics & numerical data
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Patient Readmission/statistics & numerical data
KW - Prospective Studies
KW - Risk Factors
KW - Surgical Wound Infection/epidemiology
KW - Treatment Outcome
UR - https://www.scopus.com/pages/publications/84868208205
U2 - 10.1016/j.ajic.2011.10.015
DO - 10.1016/j.ajic.2011.10.015
M3 - Article
C2 - 22325729
SN - 0196-6553
VL - 40
SP - 815
EP - 819
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 9
ER -
