Current outcomes and predictors of treatment failure in patients with surgical site infection after elective colorectal surgery. A multicentre prospective cohort study.
J Infect
; 74(6): 555-563, 2017 06.
Article
em En
| MEDLINE
| ID: mdl-28315721
ABSTRACT
OBJECTIVE:
To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery.METHODS:
A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery.RESULTS:
Of 3701 patients, 669 (18.1%) developed SSI; 336 (9.1%) were organ-space infections. Among patients with organ-space SSI, 81.2% required source control 60.4% reoperation and 20.8% percutaneous/transrectal drainage. Overall treatment failure rate was 21.7% 9% in incisional SSIs and 34.2% in organ-space SSIs (p < 0.001). Median length of stay was 15 days (IQR 9-22) for incisional SSIs and 24 days (IQR 17-35) for organ-space SSIs (p < 0.001). One hundred and twenty-seven patients (19%) required readmission and 35 patients died (5.2%). Risk factors for treatment failure among patients with organ-space SSI were age ≥65 years (OR 1.83, 95% CI 1.07-1.83), laparoscopy (OR 1.7, 95% CI 1.06-2.77), and reoperation (OR 2.8, 95% CI 1.7-4.6).CONCLUSIONS:
Rates of SSI and treatment failure in organ-space SSI after elective colorectal surgery are notably high. Careful attention should be paid to older patients with previous laparoscopy requiring reoperation for organ-space SSI, so that treatment failure can be identified early.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecção da Ferida Cirúrgica
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Falha de Tratamento
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Cirurgia Colorretal
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article