Crohn's disease but not diverticulitis is an independent risk factor for surgical site infections in colectomy

J Gastrointest Surg. 2014 Oct;18(10):1817-23. doi: 10.1007/s11605-014-2602-5. Epub 2014 Aug 5.

Abstract

Introduction: Surgical site infections (SSIs) after colectomy for colon cancer (CC), Crohn's disease (CD), and diverticulitis (DD) significantly impact both the immediate postoperative course and long-term disease-specific outcomes. We aim to profile the effect of diagnosis on SSI after segmental colectomy using the National Surgical Quality Improvement Program (NSQIP) data set.

Method: NSQIP data from 2006 to 2011 were investigated, and segmental colectomy procedures performed for the diagnoses of Crohn's disease, DD, and colon malignancy were included. SSI complications were compared by diagnosis using univariate and multivariate analysis.

Result: We included 35,557 colectomy cases in the analysis. CD had the highest rate of postoperative SSI (17 vs. 13% DD vs. 10% CC; p < 0.001). Using CC as the comparison group and controlling for multiple variables, the multivariate analysis showed that the CD group had an increased risk for acquiring at least one SSI (odds ratio (OR) = 1.38, p ≤ 0.001), deep incisional SSI (OR = 1.85, p = 0.03), and organ space SSI (OR = 1.51, p = 0.02).

Conclusion: For patients undergoing segmental colectomy in the NSQIP data set, statistically significant increases in SSI are seen in CD, but not DD, when compared to CC, thus confirming CD as an independent risk factor for SSI.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Colectomy*
  • Crohn Disease / complications
  • Crohn Disease / diagnosis
  • Crohn Disease / surgery*
  • Diverticulitis, Colonic / diagnosis
  • Diverticulitis, Colonic / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Iowa / epidemiology
  • Length of Stay / trends
  • Male
  • Middle Aged
  • Odds Ratio
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology*