43 - Freie Mitteilung
16. Mai 2019, 08:30 - 10:00, Szenario 1, 5. OG
Prognostic risk factor for surgical site infection in colon surgery
F. Frehner1, R. Rosenberg1, S. Lamm1, R. Galli1, J. Roth2, A. Widmer2, Presenter: F. Frehner1 (1Liestal, 2Basel)
Colon surgery in Switzerland is associated with a surgical site infection (SSI) rate of 13.7 % in 2017. SSIs prolong hospital stay and increase morbidity and mortality. The national center for infection prevention (Swissnoso) established a surveillance program and monitors postoperative surgical site infections. However, risk factors for SSI may differ between regions. Our aim was to identify prognostic risk factors which correlate with increased surgical site infections.
We analyzed the Swiss Noso data of all patients, which underwent colon surgery between October 2010 and July 2018 of three cantonal hospitals. Individual, surgical and hospital characteristics were identified and analyzed statistically.
1,391 colon surgeries were performed during the analyzed period. The overall rate of SSIs was 10.6 %. Emergencies accounted for 38.5% of all interventions under study, with an associated mortality within 30 days of 3.8%. 66.4% of operations were performed in hospital A with a surgical site infection rate of 12.2%, 28.7% of operations in hospital B with a SSI rate of 6.5% and 5.0% of operations in hospital C with a SSI rate of 11.6%. Independent risk factors were age of patients with a adjusted hazard ratio (HR) of 1.02 (p>0.001; 95% CI: 1.016-1023), BMI > 30 kg/m2 with a HR 2.53 95% CI 1.28 – 5.00, hospital HR 1.45 with 95% CI 1.19-1.77), type of surgery (emergency vs. elective) HR 0.51 with a 95% CI 0.31 – 0.84 and year of intervention HR 1.24 (95% CI 1.09-1.40). Antimicrobial prophylaxis <60minutes prior to incision, NNIS risk index, duration of surgery and gender were not statistically different.
Analyses in addition to the overall report of Swissnoso provides additional information on potential risk factors for focusing preventive strategies on specific factors not obvious in the national overall analyses.