Incidence, risk factors and outcome of infection in a 1-year hysterectomy cohort: a prospective follow-up study

A prospective study was performed following 687 patients who underwent abdo minal, vaginal and laparoscopic hysterectomy for benign conditions in Turku University Hospital. This study evaluates and compares infection after hys tertectomy and determines risk factors associated with postoperative infect ion. Infective episodes were recorded during hospital stay, convalescence f or 4 to 6 weeks at home and for 1 year of follow-up. Factors found to be st atistically significant fur hospital-acquired infection on univariate analy sis were subsequently assessed by means of multivariate analysis. During th e hospital stay 23.7% of the study. population became infected, 38.1% after vaginal hysterectomy: 23.4% after abdominal hysterectomy and 3.0% after la paroscopic hysterectomy. Over half of all hospital-acquired infections were lower urinary tract infections. Infection during convalescence occurred in 19.2% of patients: 29.5% in the vaginal hysterectomy group, 17.4%. in the abdominal hysterectomy group and 16.7% in the laparoscopic hysterectomy gro up. One year of follow-up did not find any infection directly attributable to surgery Five factors were found to be related to in-hospital infection o n multivariate analysis. These were lack of antibiotic prophylaxis, blood l oss during operation, intermittent catheterization, anaemia and medication for urinary or bowel dysfunction after operation. (C) 2000 The Hospital Inf ection Society.