Timing of surgical site infection and pulmonary complications after laparotomy

Ossian Gundel; Sofie Kirchhoff Gundersen; Rikke Maria Dahl; Lars Nannestad Jørgensen; Lars S Rasmussen; Jørn Wetterslev; Ditte Sæbye; Christian S Meyhoff

doi:10.1016/j.ijsu.2018.02.022

Timing of surgical site infection and pulmonary complications after laparotomy

Ossian Gundel, Sofie Kirchhoff Gundersen, Rikke Maria Dahl, Lars Nannestad Jørgensen, Lars S Rasmussen, Jørn Wetterslev, Ditte Sæbye, Christian S Meyhoff

Institut for Klinisk Medicin

5 Citationer (Scopus)

Abstract

BACKGROUND: Surgical site infection (SSI) and other postoperative complications are associated with high costs, morbidity, secondary surgery, and mortality. Many studies have identified factors that may prevent SSI and pulmonary complications, but it is important to know when they in fact occur. The aim of this study was to investigate the diagnostic timing of surgical site infections and pulmonary complications after laparotomy.

MATERIAL AND METHODS: This is a secondary analysis of the PROXI trial which was a randomized clinical trial conducted in 1400 patients undergoing elective or emergent laparotomy. Patients were randomly allocated to either 80% or 30% perioperative inspiratory oxygen fraction.

RESULTS: SSI or pulmonary complications were diagnosed in 24.2% (95% CI: 22.0%-26.5%) of the patients at a median of 9 days [IQR: 5-15] after surgery. Most common was surgical site infection (19.6%); median time 10 days after surgery [IQR: 7-18]. The corresponding figures for anastomotic leakage was 5.7%, 8 days [IQR: 6-10]; pneumonia 3.5%, 5 days [IQR: 3-9]; and respiratory failure 2.3%, 3 days [IQR: 1-8]. The oxygen allocation was not significantly related to time of diagnosis for postoperative surgical site infections or pulmonary complications.

CONCLUSION: A high percentage of patients undergoing laparotomy develop a postoperative complication. This study adds new knowledge by identifying time intervals within which medical professionals should be aware of surgical site infections and pulmonary complications in order to initiate appropriate treatment of the patients.

Originalsprog	Engelsk
Tidsskrift	International Journal of Surgery
Vol/bind	52
Sider (fra-til)	56-60
ISSN	1743-9191
DOI	https://doi.org/10.1016/j.ijsu.2018.02.022
Status	Udgivet - apr. 2018

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10.1016/j.ijsu.2018.02.022

Citationsformater

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title = "Timing of surgical site infection and pulmonary complications after laparotomy",

abstract = "BACKGROUND: Surgical site infection (SSI) and other postoperative complications are associated with high costs, morbidity, secondary surgery, and mortality. Many studies have identified factors that may prevent SSI and pulmonary complications, but it is important to know when they in fact occur. The aim of this study was to investigate the diagnostic timing of surgical site infections and pulmonary complications after laparotomy.MATERIAL AND METHODS: This is a secondary analysis of the PROXI trial which was a randomized clinical trial conducted in 1400 patients undergoing elective or emergent laparotomy. Patients were randomly allocated to either 80% or 30% perioperative inspiratory oxygen fraction.RESULTS: SSI or pulmonary complications were diagnosed in 24.2% (95% CI: 22.0%-26.5%) of the patients at a median of 9 days [IQR: 5-15] after surgery. Most common was surgical site infection (19.6%); median time 10 days after surgery [IQR: 7-18]. The corresponding figures for anastomotic leakage was 5.7%, 8 days [IQR: 6-10]; pneumonia 3.5%, 5 days [IQR: 3-9]; and respiratory failure 2.3%, 3 days [IQR: 1-8]. The oxygen allocation was not significantly related to time of diagnosis for postoperative surgical site infections or pulmonary complications.CONCLUSION: A high percentage of patients undergoing laparotomy develop a postoperative complication. This study adds new knowledge by identifying time intervals within which medical professionals should be aware of surgical site infections and pulmonary complications in order to initiate appropriate treatment of the patients.",

keywords = "Adult, Aged, Elective Surgical Procedures/adverse effects, Emergency Treatment/adverse effects, Female, Humans, Laparotomy/adverse effects, Lung Diseases/epidemiology, Male, Middle Aged, Oxygen Inhalation Therapy/methods, Surgical Wound Infection/epidemiology, Time Factors",

author = "Ossian Gundel and Gundersen, {Sofie Kirchhoff} and Dahl, {Rikke Maria} and J{\o}rgensen, {Lars Nannestad} and Rasmussen, {Lars S} and J{\o}rn Wetterslev and Ditte S{\ae}bye and Meyhoff, {Christian S}",

year = "2018",

month = apr,

doi = "10.1016/j.ijsu.2018.02.022",

language = "English",

volume = "52",

pages = "56--60",

journal = "International Journal of Surgery",

issn = "1743-9191",

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TY - JOUR

T1 - Timing of surgical site infection and pulmonary complications after laparotomy

AU - Gundel, Ossian

AU - Gundersen, Sofie Kirchhoff

AU - Dahl, Rikke Maria

AU - Jørgensen, Lars Nannestad

AU - Rasmussen, Lars S

AU - Wetterslev, Jørn

AU - Sæbye, Ditte

AU - Meyhoff, Christian S

PY - 2018/4

Y1 - 2018/4

N2 - BACKGROUND: Surgical site infection (SSI) and other postoperative complications are associated with high costs, morbidity, secondary surgery, and mortality. Many studies have identified factors that may prevent SSI and pulmonary complications, but it is important to know when they in fact occur. The aim of this study was to investigate the diagnostic timing of surgical site infections and pulmonary complications after laparotomy.MATERIAL AND METHODS: This is a secondary analysis of the PROXI trial which was a randomized clinical trial conducted in 1400 patients undergoing elective or emergent laparotomy. Patients were randomly allocated to either 80% or 30% perioperative inspiratory oxygen fraction.RESULTS: SSI or pulmonary complications were diagnosed in 24.2% (95% CI: 22.0%-26.5%) of the patients at a median of 9 days [IQR: 5-15] after surgery. Most common was surgical site infection (19.6%); median time 10 days after surgery [IQR: 7-18]. The corresponding figures for anastomotic leakage was 5.7%, 8 days [IQR: 6-10]; pneumonia 3.5%, 5 days [IQR: 3-9]; and respiratory failure 2.3%, 3 days [IQR: 1-8]. The oxygen allocation was not significantly related to time of diagnosis for postoperative surgical site infections or pulmonary complications.CONCLUSION: A high percentage of patients undergoing laparotomy develop a postoperative complication. This study adds new knowledge by identifying time intervals within which medical professionals should be aware of surgical site infections and pulmonary complications in order to initiate appropriate treatment of the patients.

AB - BACKGROUND: Surgical site infection (SSI) and other postoperative complications are associated with high costs, morbidity, secondary surgery, and mortality. Many studies have identified factors that may prevent SSI and pulmonary complications, but it is important to know when they in fact occur. The aim of this study was to investigate the diagnostic timing of surgical site infections and pulmonary complications after laparotomy.MATERIAL AND METHODS: This is a secondary analysis of the PROXI trial which was a randomized clinical trial conducted in 1400 patients undergoing elective or emergent laparotomy. Patients were randomly allocated to either 80% or 30% perioperative inspiratory oxygen fraction.RESULTS: SSI or pulmonary complications were diagnosed in 24.2% (95% CI: 22.0%-26.5%) of the patients at a median of 9 days [IQR: 5-15] after surgery. Most common was surgical site infection (19.6%); median time 10 days after surgery [IQR: 7-18]. The corresponding figures for anastomotic leakage was 5.7%, 8 days [IQR: 6-10]; pneumonia 3.5%, 5 days [IQR: 3-9]; and respiratory failure 2.3%, 3 days [IQR: 1-8]. The oxygen allocation was not significantly related to time of diagnosis for postoperative surgical site infections or pulmonary complications.CONCLUSION: A high percentage of patients undergoing laparotomy develop a postoperative complication. This study adds new knowledge by identifying time intervals within which medical professionals should be aware of surgical site infections and pulmonary complications in order to initiate appropriate treatment of the patients.

KW - Adult

KW - Aged

KW - Elective Surgical Procedures/adverse effects

KW - Emergency Treatment/adverse effects

KW - Female

KW - Humans

KW - Laparotomy/adverse effects

KW - Lung Diseases/epidemiology

KW - Male

KW - Middle Aged

KW - Oxygen Inhalation Therapy/methods

KW - Surgical Wound Infection/epidemiology

KW - Time Factors

U2 - 10.1016/j.ijsu.2018.02.022

DO - 10.1016/j.ijsu.2018.02.022

M3 - Journal article

C2 - 29455044

SN - 1743-9191

VL - 52

SP - 56

EP - 60

JO - International Journal of Surgery

JF - International Journal of Surgery

ER -

Timing of surgical site infection and pulmonary complications after laparotomy

Abstract

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