Superficial Surgical Infections in Operative Abdominal Trauma Patients: A Trauma Quality Improvement Database Analysis
| Autor: | Thomas W. Carver, Jacob R. Peschman, Christopher M. Dodgion, Ryan DeAngelis, Samantha Durbin, David Milia |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Blood transfusion Adolescent Exploratory laparotomy medicine.medical_treatment Abdominal Injuries Young Adult 03 medical and health sciences Injury Severity Score 0302 clinical medicine Risk Factors medicine Hollow viscus Humans Surgical Wound Infection Aged Retrospective Studies Laparotomy business.industry Incidence (epidemiology) Odds ratio Middle Aged medicine.disease Quality Improvement United States Surgery Abdominal trauma 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business Body mass index |
| Zdroj: | Journal of Surgical Research. 243:496-502 |
| ISSN: | 0022-4804 |
| Popis: | Background Surgical site infections (SSIs) have a substantial impact on economic and health indices for patients and health-care institutions. The aim of this study was to identify risk factors for superficial SSIs (sSSIs) in operative abdominal trauma patients using a national cohort. Methods A retrospective analysis of adult trauma patients treated within the Trauma Quality Improvement Database who underwent an exploratory laparotomy from 2010 to 2015 was performed. Risk factors for infection were evaluated using χ2, Wilcoxon rank-sum, and multivariate logistic regression. Results In total, 41,034 patients underwent an exploratory laparotomy for trauma. There were 18,538 (45.6%) penetrating injuries. Additionally, 10,938 (26.7%) patients suffered a hollow viscus injury with one (8484; 20.7%), two (2188; 5.3%), or three or more (266; 0.7%) hollow viscus organs injured, respectively. The sSSI rate was 4.3%. On multivariate analysis, colonic injuries conferred the greatest single organ independent risk for sSSIs (odds ratio [OR] 2.88 [2.41-3.44]), followed by duodenal injuries (OR 1.99 [1.24-3.17]), small bowel injuries (OR 1.54 [1.28-1.84]), gastric injuries (OR 1.41 [1.06-1.89]), body mass index >30 (1.32 [1.14-1.54]), severe Injury Severity Score (16-25) (OR 1.43 [1.19-1.74]), profound Injury Severity Score (>25) (OR 1.76 [1.44-2.15]), and increasing number of hollow viscus injuries with one (OR 2.75 [2.33-3.26]), two (OR 3.82 [2.98-4.89]), or three (OR 6.85 [4.20-11.17]) organs injured, respectively. Conclusions The incidence of sSSI in operative abdominal trauma patients increases with increased body mass index, increased age, location of injury, blood transfusion need, and increasing number hollow viscus injuries. Consideration should be given to avoiding primary skin closure in patients with these risk factors as a way to mitigate SSIs in this patient population. |
| Databáze: | OpenAIRE |
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