RISK-FACTORS FOR INFECTIOUS COMPLICATIONS AFTER ABDOMINAL-SURGERY FORMALIGNANT DISEASE

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.