Incidence and predictors of deep incisional and organ/space surgical site infection following radical cystectomy
Copyright © 2023 Elsevier Inc. All rights reserved..
OBJECTIVE: To investigate clinical risk factors associated with postoperative deep incisional or organ/space surgical site infections (SSI) following radical cystectomy (RC) in a well characterized and large contemporary cohort.
METHODS: We used the American College of Surgeons National Surgical Quality Improvement Program database to identify adult patients who underwent RC for bladder cancer between 2015 and 2020 (n = 13,081). We conducted multivariable-adjusted logistic regression and Cox adjusted proportional hazards regression analysis to identify clinical predictors of deep incisional or organ/space SSI in the 30-day postoperative-period following RC.
RESULTS: Deep incisional or organ/space SSI risk increased with continent urinary diversion (HR = 1.61, 95% CI: 1.38-1.88; P < 0.001), obesity (HR = 1.60, 95% CI: 1.35-1.90; P < 0.001), diabetes mellitus (HR = 1.30, 95% CI: 1.13-1.51; P < 0.001), and being functionally dependent before surgery (HR = 2.09, 95% CI: 1.44-3.03; P < 0.001).
CONCLUSIONS: Postoperative deep incisional or organ/space SSIs following RC occur more frequently in patients who were obese, diabetic, functionally dependent before surgery, and those who underwent continent urinary diversion. These findings may assist urologists in preoperative counseling, medical optimization, and choice of urinary diversion approach, as well as improved patient monitoring and identification of candidates for intervention postoperatively.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:41 |
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| Enthalten in: |
Urologic oncology - 41(2023), 11 vom: 01. Nov., Seite 455.e17-455.e24 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Blachman-Braun, Ruben [VerfasserIn] |
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| Links: |
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| Themen: |
Cystectomy |
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| Anmerkungen: |
Date Completed 05.12.2023 Date Revised 11.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.urolonc.2023.06.016 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360244033 |
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| 245 | 1 | 0 | |a Incidence and predictors of deep incisional and organ/space surgical site infection following radical cystectomy |
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| 500 | |a Date Revised 11.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To investigate clinical risk factors associated with postoperative deep incisional or organ/space surgical site infections (SSI) following radical cystectomy (RC) in a well characterized and large contemporary cohort | ||
| 520 | |a METHODS: We used the American College of Surgeons National Surgical Quality Improvement Program database to identify adult patients who underwent RC for bladder cancer between 2015 and 2020 (n = 13,081). We conducted multivariable-adjusted logistic regression and Cox adjusted proportional hazards regression analysis to identify clinical predictors of deep incisional or organ/space SSI in the 30-day postoperative-period following RC | ||
| 520 | |a RESULTS: Deep incisional or organ/space SSI risk increased with continent urinary diversion (HR = 1.61, 95% CI: 1.38-1.88; P < 0.001), obesity (HR = 1.60, 95% CI: 1.35-1.90; P < 0.001), diabetes mellitus (HR = 1.30, 95% CI: 1.13-1.51; P < 0.001), and being functionally dependent before surgery (HR = 2.09, 95% CI: 1.44-3.03; P < 0.001) | ||
| 520 | |a CONCLUSIONS: Postoperative deep incisional or organ/space SSIs following RC occur more frequently in patients who were obese, diabetic, functionally dependent before surgery, and those who underwent continent urinary diversion. These findings may assist urologists in preoperative counseling, medical optimization, and choice of urinary diversion approach, as well as improved patient monitoring and identification of candidates for intervention postoperatively | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cystectomy | |
| 650 | 4 | |a Diabetes mellitus | |
| 650 | 4 | |a Obesity | |
| 650 | 4 | |a Surgical wound infection | |
| 650 | 4 | |a Urinary diversion | |
| 700 | 1 | |a Gurayah, Aaron A |e verfasserin |4 aut | |
| 700 | 1 | |a Mason, Matthew M |e verfasserin |4 aut | |
| 700 | 1 | |a Hougen, Helen Y |e verfasserin |4 aut | |
| 700 | 1 | |a Gonzalgo, Mark L |e verfasserin |4 aut | |
| 700 | 1 | |a Nahar, Bruno |e verfasserin |4 aut | |
| 700 | 1 | |a Punnen, Sanoj |e verfasserin |4 aut | |
| 700 | 1 | |a Parekh, Dipen J |e verfasserin |4 aut | |
| 700 | 1 | |a Ritch, Chad R |e verfasserin |4 aut | |
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