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Preoperative risk factors of incisional surgical site infection in severe or intractable ulcerative colitis

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Abstract

Purpose

The present study explored preoperative risk factors (predictors) of incisional surgical site infection (I-SSI) in severe or intractable ulcerative colitis (UC).

Methods

This was a retrospective study of 230 consecutive patients who underwent primary surgery for UC. Patients whose surgical indications were UC with cancer or dysplasia were excluded. SSI was defined as an infection according to the Centers for Disease Control and Prevention Guidelines. Preoperative variables were examined by univariate, receiver operating characteristic curve, and multivariate analyses.

Results

We analyzed 208 patients in this study. In a multivariate logistic analysis, C-reactive protein (CRP) ≥ 1.7 mg/dl [odds ratio (OR) 5.35; 95% confidence interval (CI) 1.50–19.06; p = 0.01), albumin ≤ 2.4 g/dl (OR 5.77; 95% CI 1.41–23.57; p = 0.02), and preoperative blood transfusion (OR 3.21; 95% CI 1.04–9.96; p = 0.04) were predictors of I-SSI. Patients with all predictors had a more than 50% incidence of I-SSI, a higher incidence of all severe complications (13.6% vs. 3.2%; p = 0.02), and a longer postoperative hospital stay (19.5 vs. 17.0 days, p = 0.04) than the other patients.

Conclusions

CRP ≥ 1.7 mg/dl, albumin ≤ 2.4 g/dl, and transfusion are predictors of I-SSI in severe or intractable UC. Clinician should carefully evaluate the surgical options before these predictors appear.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Kenichiro Toritani, Hironori Fukuoka, Atsushi Ishibe & Itaru Endo

  2. Inflammatory Bowel Disease Center, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan

    Kenichiro Toritani, Hideaki Kimura & Reiko Kunisaki

  3. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan

    Jun Watanabe

Authors
  1. Kenichiro Toritani
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  2. Hideaki Kimura
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Correspondence to Hideaki Kimura.

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Toritani, K., Kimura, H., Fukuoka, H. et al. Preoperative risk factors of incisional surgical site infection in severe or intractable ulcerative colitis. Surg Today 52, 475–484 (2022). https://doi.org/10.1007/s00595-021-02354-x

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  • DOI: https://doi.org/10.1007/s00595-021-02354-x

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