Understanding risk factors and microbial trends implicated in the development of Whipple-related surgical-site infections
Abstract Objective: The purpose of this study is to understand the role of risk factors and postoperative complications seen in patients undergoing Whipple procedures in the development of surgical site infections. Our secondary goal was to evaluate whether microbial patterns differed between preo...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2023-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X22003771/type/journal_article |
| _version_ | 1811157245831938048 |
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| author | Wendy Feng Ahmer Irfan Molly Fleece Vikas Dudeja Sushanth Reddy Salila Hashmi J. Bart Rose Rachael A. Lee |
| author_facet | Wendy Feng Ahmer Irfan Molly Fleece Vikas Dudeja Sushanth Reddy Salila Hashmi J. Bart Rose Rachael A. Lee |
| author_sort | Wendy Feng |
| collection | DOAJ |
| description |
Abstract
Objective:
The purpose of this study is to understand the role of risk factors and postoperative complications seen in patients undergoing Whipple procedures in the development of surgical site infections. Our secondary goal was to evaluate whether microbial patterns differed between preoperative antibiotic classes, offering insight into the effectiveness of current practices while promoting antibiotic stewardship.
Design:
We performed a retrospective cohort study comparing patients with and without SSIs.
Setting:
This study was conducted at a tertiary-care center in the southeastern United States.
Participants:
Patients who underwent a Whipple procedure between 2012 and 2021 were acquired from the National Surgical Quality Improvement Program (NSQIP) database.
Results:
Patients with a bleeding disorder reported higher SSI rates (P = .04), whereas patients with a biliary stent reported lower surgical site infection (SSI) rates (P = .02) Those with postoperative complications had higher SSI rates, including delayed gastric emptying (P < .001) and pancreatic fistula (P < .001). Patients with longer operative times were 1.002 times more likely to develop SSIs (adjusted odds ratio [aOR], 1.002; 95% confidence interval [CI], 1.001–1.004; P = .006) whereas surgical indications for malignancy correlated with decreased SSIs risk (aOR, 0.578; 95% CI, 0.386–866) when adjusting for body mass index, surgical indication, and duration of surgical procedure.
Conclusions:
Optimizing preoperative management of modifiable risk factors for patients undergoing pancreatoduodenectomies and decreasing operative times may reduce SSI rates and patient and hospital burden. Further research is needed to understand whether stent placement reduces SSI risk in pancreatoduodenectomy.
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| first_indexed | 2024-04-10T05:03:59Z |
| format | Article |
| id | doaj.art-abf009dfa64d4b3787e452efba7967cf |
| institution | Directory Open Access Journal |
| issn | 2732-494X |
| language | English |
| last_indexed | 2024-04-10T05:03:59Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj.art-abf009dfa64d4b3787e452efba7967cf2023-03-09T12:27:53ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2023-01-01310.1017/ash.2022.377Understanding risk factors and microbial trends implicated in the development of Whipple-related surgical-site infectionsWendy Feng0https://orcid.org/0000-0002-9734-8809Ahmer Irfan1https://orcid.org/0000-0001-8339-652XMolly Fleece2Vikas Dudeja3Sushanth Reddy4Salila Hashmi5J. Bart Rose6https://orcid.org/0000-0002-0471-3978Rachael A. Lee7https://orcid.org/0000-0002-9701-8156University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United StatesUniversity of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, Alabama, United StatesUniversity of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United StatesUniversity of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, Alabama, United StatesUniversity of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, Alabama, United StatesUniversity of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, Alabama, United StatesUniversity of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, Alabama, United StatesUniversity of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, United States Abstract Objective: The purpose of this study is to understand the role of risk factors and postoperative complications seen in patients undergoing Whipple procedures in the development of surgical site infections. Our secondary goal was to evaluate whether microbial patterns differed between preoperative antibiotic classes, offering insight into the effectiveness of current practices while promoting antibiotic stewardship. Design: We performed a retrospective cohort study comparing patients with and without SSIs. Setting: This study was conducted at a tertiary-care center in the southeastern United States. Participants: Patients who underwent a Whipple procedure between 2012 and 2021 were acquired from the National Surgical Quality Improvement Program (NSQIP) database. Results: Patients with a bleeding disorder reported higher SSI rates (P = .04), whereas patients with a biliary stent reported lower surgical site infection (SSI) rates (P = .02) Those with postoperative complications had higher SSI rates, including delayed gastric emptying (P < .001) and pancreatic fistula (P < .001). Patients with longer operative times were 1.002 times more likely to develop SSIs (adjusted odds ratio [aOR], 1.002; 95% confidence interval [CI], 1.001–1.004; P = .006) whereas surgical indications for malignancy correlated with decreased SSIs risk (aOR, 0.578; 95% CI, 0.386–866) when adjusting for body mass index, surgical indication, and duration of surgical procedure. Conclusions: Optimizing preoperative management of modifiable risk factors for patients undergoing pancreatoduodenectomies and decreasing operative times may reduce SSI rates and patient and hospital burden. Further research is needed to understand whether stent placement reduces SSI risk in pancreatoduodenectomy. https://www.cambridge.org/core/product/identifier/S2732494X22003771/type/journal_article |
| spellingShingle | Wendy Feng Ahmer Irfan Molly Fleece Vikas Dudeja Sushanth Reddy Salila Hashmi J. Bart Rose Rachael A. Lee Understanding risk factors and microbial trends implicated in the development of Whipple-related surgical-site infections Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Understanding risk factors and microbial trends implicated in the development of Whipple-related surgical-site infections |
| title_full | Understanding risk factors and microbial trends implicated in the development of Whipple-related surgical-site infections |
| title_fullStr | Understanding risk factors and microbial trends implicated in the development of Whipple-related surgical-site infections |
| title_full_unstemmed | Understanding risk factors and microbial trends implicated in the development of Whipple-related surgical-site infections |
| title_short | Understanding risk factors and microbial trends implicated in the development of Whipple-related surgical-site infections |
| title_sort | understanding risk factors and microbial trends implicated in the development of whipple related surgical site infections |
| url | https://www.cambridge.org/core/product/identifier/S2732494X22003771/type/journal_article |
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