PD62-12 CONCURRENT UROLOGIC SURGERIES INCREASE THE RISK OF INFECTION: A NATIONAL DATABASE STUDY

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia II1 Apr 2018PD62-12 CONCURRENT UROLOGIC SURGERIES INCREASE THE RISK OF INFECTION: A NATIONAL DATABASE STUDY Valary Raup, Ramy Abou Ghayda, H. Abraham Chiang, Julie Szymaniak, Steven L. Chang, Benjamin I. Chung, and Martin Kathrins Valary RaupValary Raup More articles by this author , Ramy Abou GhaydaRamy Abou Ghayda More articles by this author , H. Abraham ChiangH. Abraham Chiang More articles by this author , Julie SzymaniakJulie Szymaniak More articles by this author , Steven L. ChangSteven L. Chang More articles by this author , Benjamin I. ChungBenjamin I. Chung More articles by this author , and Martin KathrinsMartin Kathrins More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2848AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Surgical infections are a vexing problem that put significant strain on our healthcare system. There have been multiple studies looking at infection rates after various solo urologic surgeries. We sought to examine the rates of postoperative infection when endoscopic surgery is performed concurrently with another type of urologic surgery using a large national database. METHODS The Premier Hospital Database (2003-2015) was queried using International Classification of Diseases (ICD-9) procedural codes (CPT) codes for urologic procedures split into 7 categories: endoscopic, urethral, scrotal, testes, penile, implants, spermatic cord/vas. Endoscopic procedures were run against the other 6 categories of urologic surgery. Infection rates were evaluated divided into subcategories of soft tissue infection (STI), sepsis, clostridium difficile (C. diff), urinary tract infection (UTI), pneumonia, and other infections. We assessed for a relationship between the type of concurrent procedure and infection, adjusting for patient and hospital characteristics. RESULTS A total of 487,725 patients were identified to have undergone endoscopic procedures, 2.7% of which also underwent a concurrent urologic procedure (n=13,546). The most common concurrent procedure was urethral (86%), followed by penile procedures (8%), scrotal and implant procedures (2% each), and seminal vesicle/vas procedures (1%). Concurrent urologic surgery was associated with Caucasian race (75%, p<0.001), male gender (79%, p<0.001), marriage (62%, p<0.001), Charleston Comorbidity Index 0-1 (63.5%, p<0.001), Medicare payor (62%, p=0.046), non-teaching hospitals (68%, p<0.001), smaller hospitals (p<0.001), and being in the Midwest region (p<0.001). Accounting for patient/hospital factors, urethral and penile procedures were strongly associated with increased rates of overall infections and UTIs, while scrotal procedures were strongly associated with STI and implant procedures were strongly associated with other infections not specifically characterized (all p<0.0001) (Table 1). CONCLUSIONS Concurrent urologic surgery is uncommon but associated with increased infection rates. Further studies are needed to better delineate how we can tailor our clinical practices and antibiotic choice to better prevent these infections. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1161 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Valary Raup More articles by this author Ramy Abou Ghayda More articles by this author H. Abraham Chiang More articles by this author Julie Szymaniak More articles by this author Steven L. Chang More articles by this author Benjamin I. Chung More articles by this author Martin Kathrins More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...