Current outcomes and predictors of treatment failure in patients with surgical site infection after elective colorectal surgery. A multicentre prospective cohort study. Gomila, A., Badia, J. M., Carratalà, J., Serra-Aracil, X., Shaw, E., Diaz-Brito, V., Castro, A., Espejo, E., Nicolás, C., Piriz, M., Brugués, M., Obradors, J., Lérida, A., Cuquet, J., Limón, E., Gudiol, F., Pujol, M., & VINCat Colon Surgery Group Journal of Infection, 74(6):555–563, 2017.
doi  abstract   bibtex   
OBJECTIVE: To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery. METHODS: A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery. RESULTS: Of 3701 patients, 669 (18.1%) developed SSI; 336 (9.1%) were organ-space infections. Among patients with organ-space SSI, 81.2% required source control: 60.4% reoperation and 20.8% percutaneous/transrectal drainage. Overall treatment failure rate was 21.7%: 9% in incisional SSIs and 34.2% in organ-space SSIs (p \textless 0.001). Median length of stay was 15 days (IQR 9-22) for incisional SSIs and 24 days (IQR 17-35) for organ-space SSIs (p \textless 0.001). One hundred and twenty-seven patients (19%) required readmission and 35 patients died (5.2%). Risk factors for treatment failure among patients with organ-space SSI were age ≥65 years (OR 1.83, 95% CI: 1.07-1.83), laparoscopy (OR 1.7, 95% CI: 1.06-2.77), and reoperation (OR 2.8, 95% CI: 1.7-4.6). CONCLUSIONS: Rates of SSI and treatment failure in organ-space SSI after elective colorectal surgery are notably high. Careful attention should be paid to older patients with previous laparoscopy requiring reoperation for organ-space SSI, so that treatment failure can be identified early.
@article{gomila_current_2017,
	title = {Current outcomes and predictors of treatment failure in patients with surgical site infection after elective colorectal surgery. {A} multicentre prospective cohort study},
	volume = {74},
	issn = {1532-2742},
	doi = {10.1016/j.jinf.2017.03.002},
	abstract = {OBJECTIVE: To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery.
METHODS: A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery.
RESULTS: Of 3701 patients, 669 (18.1\%) developed SSI; 336 (9.1\%) were organ-space infections. Among patients with organ-space SSI, 81.2\% required source control: 60.4\% reoperation and 20.8\% percutaneous/transrectal drainage. Overall treatment failure rate was 21.7\%: 9\% in incisional SSIs and 34.2\% in organ-space SSIs (p {\textless} 0.001). Median length of stay was 15 days (IQR 9-22) for incisional SSIs and 24 days (IQR 17-35) for organ-space SSIs (p {\textless} 0.001). One hundred and twenty-seven patients (19\%) required readmission and 35 patients died (5.2\%). Risk factors for treatment failure among patients with organ-space SSI were age ≥65 years (OR 1.83, 95\% CI: 1.07-1.83), laparoscopy (OR 1.7, 95\% CI: 1.06-2.77), and reoperation (OR 2.8, 95\% CI: 1.7-4.6).
CONCLUSIONS: Rates of SSI and treatment failure in organ-space SSI after elective colorectal surgery are notably high. Careful attention should be paid to older patients with previous laparoscopy requiring reoperation for organ-space SSI, so that treatment failure can be identified early.},
	language = {eng},
	number = {6},
	journal = {Journal of Infection},
	author = {Gomila, Aina and Badia, Josep Ma and Carratalà, Jordi and Serra-Aracil, Xavier and Shaw, Evelyn and Diaz-Brito, Vicens and Castro, Antoni and Espejo, Elena and Nicolás, Carmen and Piriz, Marta and Brugués, Montserrat and Obradors, Josefina and Lérida, Ana and Cuquet, Jordi and Limón, Enric and Gudiol, Francesc and Pujol, Miquel and {VINCat Colon Surgery Group}},
	year = {2017},
	pmid = {28315721},
	keywords = {Article, Colorectal diseases, Medicina Interna, Multidrug-resistant Gram-negative bacilli, Organ-space surgical site infections, Surgical site infections},
	pages = {555--563},
}

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