E. Velasco et al., RISK-FACTORS FOR INFECTIOUS COMPLICATIONS AFTER ABDOMINAL-SURGERY FORMALIGNANT DISEASE, American journal of infection control, 24(1), 1996, pp. 1-6
Background: The emergence of nosocomial infection as a serious complic
ation after intraabdominal operations for cancer prompted us to identi
fy major independent risk factors associated with postoperative infect
ion. Methods: Risk factors were studied in single and multivariate ana
lyses. Variables considered were remote infection, antimicrobial proph
ylaxis, preoperative stay, chemotherapy, radiotherapy, weight loss, el
ective versus emergency operation, wound class, duration of operation,
drains, sex, age, and physical status. Results: During 24 months, 236
patients were entered in the study. The overall postoperative infecti
on rate was 45.7%; the surgical site infection rate was 22.4%. Multiva
riate analysis identified three independent variables: duration of ope
ration longer than 5 hours (odds ratio 6.41, 95% confidence interval 3
.28 to 12.54), presence of remote infection at operation (odds ratio 3
.76, 95% confidence interval 1.76 to 8.03), and preoperative stay long
er than 22 days (odds ratio 2.03, 95% confidence interval 1.04 to 3.95
). The relative risk of infection increased from 3.0 when one risk fac
tor was present to 7.3 when all three risk factors were present. Concl
usions: The predictive power of our final multivariate risk index clea
rly groups these patients according to differing risk for postoperativ
e infection. This classification contributes substantially to the effe
ctiveness of infection control strategies to prevent the occurrence of
postoperative infection in the high-risk population of patients with
cancer.