Timing of postoperative infections after colectomy: evidence from NSQIP

Abstract Background We studied whether risk factors for infectious complications differed between inpatient (IP) and postdischarge (PD) periods in patients undergoing colon surgery. Methods Among partial colon resection patients in the National Surgical Quality Improvement Program (2005 to 2010), we...

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Bibliographic Details
Published in:The American journal of surgery 2016-11, Vol.212 (5), p.844-850
Main Authors: Wilson, Matthew Z., M.D., M.S, Dillon, Peter W., M.D., M.Sc., F.A.C.S, Stewart, David B., M.D., F.A.C.S, Hollenbeak, Christopher S., Ph.D
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Chronic obstructive pulmonary disease
Colectomy
Colectomy - adverse effects
Colectomy - methods
Colorectal surgery
Confidence Intervals
Diabetes
Evidence-Based Medicine
Female
Heart attacks
Heart failure
Hospital Mortality - trends
Hospitals
Humans
Hypertension
Incidence
Laparoscopy
Length of Stay
Logistic Models
Male
Medicaid
Medical personnel
Medicare
Middle Aged
Multivariate Analysis
Outcomes
Patients
Registries
Retrospective Studies
Review boards
Risk Assessment
Risk factors
Severity of Illness Index
Sex Distribution
Surgery
Surgical site infection
Surgical site infections
Surgical Wound Infection - diagnosis
Surgical Wound Infection - epidemiology
Survival Rate
Time Factors
Urinary tract diseases
Urinary tract infections
Urogenital system
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Summary:Abstract Background We studied whether risk factors for infectious complications differed between inpatient (IP) and postdischarge (PD) periods in patients undergoing colon surgery. Methods Among partial colon resection patients in the National Surgical Quality Improvement Program (2005 to 2010), we identified risk factors for superficial and deep (D-SSI) surgical site infections and urinary tract infections in the IP and PD phases of care. Results Obesity was associated with higher risk of both IP superficial surgical site infections and D-SSI (odds ratio [OR] 1.41, P < .0001 and OR 1.28, P < .0001) and increasing to OR 1.73 ( P < .0001) and OR 1.83 ( P < .0001), respectively, in the PD period. Smoking was associated with development of D-SSI, and this risk increased from IP to PD phases of care (OR 1.15, P = .02 to OR 1.54, P < .0001). Conclusions Risk factors for infections differ between IP and PD phases of care in colon surgery patients. Earlier discharge from the hospital may shift recognition of an SSI to the outpatient setting.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.12.025