Nutritional risk index as an independent predictive factor for the development of surgical site infection after pancreaticoduodenectomy
- 695 Downloads
Malnutrition has been considered a risk factor for the development of a surgical site infection (SSI). The aim of this study was to determine the relationship between preoperative nutritional screening scores and the development of SSI after pancreaticoduodenectomy.
We examined 64 patients who had undergone pancreaticoduodenectomy. Their clinical data, nutritional risk index (NRI), and nutritional risk screening 2002 (NRS-2002) score were recorded. SSIs were diagnosed according to the definitions of wound infection established by the Center for Disease Control and Prevention and were confirmed by a microbiological examination. Data were analyzed using the Fisher exact probability method and a multivariate logistic regression analysis.
SSIs developed in 21 patients (33 %). Eleven patients had wound infections, and 14 patients had an intra-abdominal abscess. A univariate analysis of perioperative factors revealed that a pancreatic fistula, the NRS-2002, and the NRI were significantly associated with the development of SSI (p < 0.05). The multivariate logistic regression analysis revealed that a pancreatic fistula and the NRI were independent risk factors for SSI. By analyzing the pre- and intra-operative factors after excluding the 11 patients with pancreatic fistulas, the NRI was still an independent risk factor for SSI.
The present study showed the NRI to be an independent factor for predicting the risk of SSI after pancreaticoduodenectomy.
KeywordsNutritional risk index SSI Pancreaticoduodenectomy
Surgical site infection
Nutritional risk screening 2002
Nutritional risk index
Body mass index
Methicillin-resistant Staphylococcus aureus
Conflict of interest
Hiroji Shinkawa and co-authors have no conflict of interest.
- 15.Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999;27(2):97–132. quiz 133–134; discussion 196.PubMedCrossRefGoogle Scholar
- 19.Perioperative total parenteral nutrition in surgical patients. The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. N Engl J Med 1991;325(8): 525–32.Google Scholar
- 25.National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004;32(8): 470–85.Google Scholar
- 44.National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1990-May 1999, issued June 1999. Am J Infect Control. 1999;27(6): 520–32.Google Scholar
- 49.Sudo T, Murakami Y, Uemura K, Hayashidani Y, Hashimoto Y, Ohge H, et al. Specific antibiotic prophylaxis based on bile cultures is required to prevent postoperative infectious complications in pancreatoduodenectomy patients who have undergone preoperative biliary drainage. World J Surg. 2007;31(11):2230–5.PubMedCrossRefGoogle Scholar