53 SURGICAL SITE INFECTIONS IN UROLOGIC SURGERY

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes I1 Apr 201253 SURGICAL SITE INFECTIONS IN UROLOGIC SURGERY Lee C. Zhao, James M. Dupree, Brian V. Le, Marc Bjurlin, and Shilajit Kundu Lee C. ZhaoLee C. Zhao Chicago, IL More articles by this author , James M. DupreeJames M. Dupree Chicago, IL More articles by this author , Brian V. LeBrian V. Le Chicago, IL More articles by this author , Marc BjurlinMarc Bjurlin Chicago, IL More articles by this author , and Shilajit KunduShilajit Kundu Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.098AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Entering the urinary tract during urologic surgery may increase risk for surgical site infections (SSI). We evaluated the rate and risk factors for SSIs in common major urologic procedures. METHODS The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is a risk-adjusted data collection mechanism for analyzing clinical outcomes data including 30-day peri-operative complications. Using NSQIP data from 2005 to 2009, we identified patients who underwent cystectomy, laparoscopic (LPx) and open prostatectomy (OPx), laparoscopic (LPNx) and open radical partial nephrectomy (OPNx), and laparoscopic (LNx) and open (ONx) radical nephrectomy. Rates of superficial, deep, and organ space SSI were investigated. RESULTS From 2005-2009, 5,378 cases were identified. Superficial SSI was found in 1.6% of urologic cases. Deep incisional infections and organ space SSI were rare (0.3% and 0.7%, respectively). Cystectomy had the highest rate of SSI at 13.4%. Patients with SSI were older (age 63.7 vs 61.5), more likely to be smokers (3.6% vs 2.3%), had higher BMI (30.8 vs 28.9), and longer operative time (261 vs 202 minutes). Length of stay was increased for patients with infectious complications (see Table 1). The average post-operative day of occurrence for superficial, deep, and organ space SSI was day 13, 11, and 15, respectively. The rate of SSI was lower for laparoscopic prostatectomy compared to open (0.9% vs 2.0%, p = 0.007), and for laparoscopic partial nephrectomy compared to open (0.8% vs 4.0%, p = 0.01). There was a trend towards lower SSI for laparoscopic nephrectomy, but this did not reach statistical significance (2.0% vs 3.7%, p = 0.08). Table 1. Procedure N Superficial SSI Deep SSI Organ Space SSI Any SSI LOS without SSI LOS with SSI Cystectomy 343 31(9.0%) 2(0.5%) 15(4.4%) 46(13.4%) 11.1 days 16.6 days LPx 2205 13(0.6%) 1(0.0%) 5(0.2%) 19(0.9%) 1.8 days 3.9 days OPx 888 12(1.4%) 4(0.4%) 3(0.3%) 18(2.0%) 3.0 days 5.1 days LPN 261 0(0.0%) 1(0.4%) 1(0.4%) 2(0.8%) 3.2 days 6.5 days OPN 405 7(1.7%) 4(1.0%) 7(1.7%) 16(4.0%) 5.3 days 20.9 days LNx 824 13(1.6%) 3(0.4%) 1(0.1%) 17(2.0%) 4.5 days 7.6 days ONx 460 11(2.4%) 2(0.4%) 5(1.1%) 17(3.7%) 6.9 days 13.2 days CONCLUSIONS Surgical site infections were rare overall at 1.6% of all major urologic cases, but most common for cystectomy. The frequency of SSI was low for nephrectomy and prostatectomy, and laparoscopic procedures appear to have lower rates of SSIs compared open procedures. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e22-e23 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lee C. Zhao Chicago, IL More articles by this author James M. Dupree Chicago, IL More articles by this author Brian V. Le Chicago, IL More articles by this author Marc Bjurlin Chicago, IL More articles by this author Shilajit Kundu Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...