|
Back to 2017 Posters
IDENTIFICATION OF PREDICTORS OF SURGICAL SITE INFECTION IN PATIENTS WITH GASTRIC CANCER UNDERGOING SURGERY WITH CURATIVE INTENT
Yuji Toiyama*, Tadanobu Shimura, Hiromi Yasuda, Shigeyuki Yoshiyama, Minako Kobayashi, Masaki Ohi, Toshimitsu Araki, Yasuhiro Inoue, Yasuhiko Mohri, Masato Kusunoki
Mie University, Tsu city, Japan
Background:
Surgical site infection (SSI) is a potentially morbid and costly complication of surgery. According to the Centers for Disease Control and Prevention classification, SSIs are categorized as superficial/deep incisional SSIs (iSSIs), and organ/space SSIs (o/sSSIs). Previous studies have reported several risk factors for SSIs after gastrectomy. However, most of these studies did not assess iSSIs and o/sSSIs separately. It is likely that the risk factors for iSSIs and o/sSSIs differ significantly. Therefore, these complications should therefore be assessed separately.
Aims:
The purpose of this study was to investigate the risk factors for iSSIs and o/sSSIs separately and identified distinct risk factors associated with these two complications in patients with gastric cancer (GC) who had undergone surgery with curative intent.
Methods:
Data on clinicopathological factors, including operative and preoperative laboratory factors, for 384 patients with GC who had undergone curative surgery were analyzed in this retrospective study to assess their associations with SSIs. All patients received prophylactic first-generation cephalosporin antibiotics (cefazolin) for 1 day, according to Japanese guidelines on hospital-acquired infection; 1.0 g of cefazolin being administered. Infusions were started soon after induction of anesthesia. Further doses of antibiotics were given every 3 h during the operation.
Results:
iSSIs and o/sSSIs occurred in 18 (4.6%) and 27 (7.0%). o/sSSIs was significantly associated with surgery-related factors such as duration of operation, blood loss, and extent of tumor. Additionally, high levels of preoperative indicators of systemic inflammation, including neutrophil counts, neutrophil/lymphocyte ratio and C-reactive protein concentrations, were significantly associated with o/sSSIs. Multivariate analyses demonstrated that preoperative neutrophil counts and duration of surgery were independent predictors for o/sSSIs, whereas only preoperative serum albumin concentration was predicted for iSSIs.
Conclusion:
High preoperative neutrophil counts and long duration of operation are independent risk factors for o/sSSIs. Having both of these factors is associated with a high risk of SSIs in patients with GC undergoing curative surgery. These two factors should therefore be considered when deciding on the duration of administration of prophylactic antimicrobial agents or whether to administer intensive therapeutic antimicrobial agents preoperatively in these patients.
Back to 2017 Posters
|
