Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer

BackgroundOrgan/space surgical site infection (organ/space SSI) is a serious postoperative complication, closely related to a poor prognosis. Few studies have attempted to stratify the risk of organ/space SSI for patients with advanced digestive system cancer. This study aimed to identify a simple r...

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Autores principales:	Chen Sun, Hui Gao, Yuelun Zhang, Lijian Pei, Yuguang Huang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	organ/space surgical site infection risk stratification advanced digestive system cancer perioperative management postoperative complication Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/ce62cf926c744224bd525f502ab903c0
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spelling	oai:doaj.org-article:ce62cf926c744224bd525f502ab903c02021-11-09T06:00:42ZRisk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer2234-943X10.3389/fonc.2021.705335https://doaj.org/article/ce62cf926c744224bd525f502ab903c02021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.705335/fullhttps://doaj.org/toc/2234-943XBackgroundOrgan/space surgical site infection (organ/space SSI) is a serious postoperative complication, closely related to a poor prognosis. Few studies have attempted to stratify the risk of organ/space SSI for patients with advanced digestive system cancer. This study aimed to identify a simple risk stratification for these patients based on perioperative factors.MethodsThe study was based on two randomized controlled trials (RCT) (NCT02715076, ChiCTR-IPR-17011099), including 839 patients undergoing elective radical resection of advanced digestive system cancer. The primary outcome was organ/space SSI within 30 days after surgery. Multivariable logistic regression model was used to identify risk factors. The risk of organ/space SSI stratified over those risk factors was compared using chi-square tests and the relative risk (RR) was estimated.ResultsAmong the 839 patients, 51 developed organ/space SSI (6.1%) within 30 days after surgery. According to the multivariable logistic regression model, 3 procedure types, including gastrectomy (OR=8.22, 95% CI: 2.71-24.87, P<0.001), colorectal resection (OR=8.65, 95% CI: 3.13-23.85, P<0.001) and pancreatoduodenectomy (OR=7.72, 95% CI: 2.95-20.21, P<0.001), as well as anaesthesia time > 4 h (OR=2.38, 95% CI: 1.08-5.27, P=0.032) and prolonged ICU stay (OR=4.10, 95% CI: 1.67-10.10, P=0.002), were risk factors for postoperative organ/space SSI. The number of risk factors was significantly associated with an increased risk of organ/space SSI (P<0.001), which was 2.8% in patients with 0-1 risk factor (RR=0.20, 95% CI: 0.11-0.35), 13.0% in patients with 2 risk factors (RR=3.64, 95% CI: 2.14-6.20) and 35.7% in patients with 3 risk factors (RR=6.41, 95% CI: 3.01-13.65).ConclusionThis study is a preliminary exploratory and provides a simple risk stratification to identify the risk of postoperative organ/space SSI for patients with advanced digestive system cancer. Further research is needed to validate and generalize the results in a wider population.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT02715076; Chinese Clinical Trial Registry [https://www.chictr.org.cn/enindex.aspx], identifier ChiCTR-IPR-17011099.Chen SunHui GaoYuelun ZhangLijian PeiLijian PeiYuguang HuangFrontiers Media S.A.articleorgan/space surgical site infectionrisk stratificationadvanced digestive system cancerperioperative managementpostoperative complicationNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	organ/space surgical site infection risk stratification advanced digestive system cancer perioperative management postoperative complication Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	organ/space surgical site infection risk stratification advanced digestive system cancer perioperative management postoperative complication Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Chen Sun Hui Gao Yuelun Zhang Lijian Pei Lijian Pei Yuguang Huang Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer
description	BackgroundOrgan/space surgical site infection (organ/space SSI) is a serious postoperative complication, closely related to a poor prognosis. Few studies have attempted to stratify the risk of organ/space SSI for patients with advanced digestive system cancer. This study aimed to identify a simple risk stratification for these patients based on perioperative factors.MethodsThe study was based on two randomized controlled trials (RCT) (NCT02715076, ChiCTR-IPR-17011099), including 839 patients undergoing elective radical resection of advanced digestive system cancer. The primary outcome was organ/space SSI within 30 days after surgery. Multivariable logistic regression model was used to identify risk factors. The risk of organ/space SSI stratified over those risk factors was compared using chi-square tests and the relative risk (RR) was estimated.ResultsAmong the 839 patients, 51 developed organ/space SSI (6.1%) within 30 days after surgery. According to the multivariable logistic regression model, 3 procedure types, including gastrectomy (OR=8.22, 95% CI: 2.71-24.87, P<0.001), colorectal resection (OR=8.65, 95% CI: 3.13-23.85, P<0.001) and pancreatoduodenectomy (OR=7.72, 95% CI: 2.95-20.21, P<0.001), as well as anaesthesia time > 4 h (OR=2.38, 95% CI: 1.08-5.27, P=0.032) and prolonged ICU stay (OR=4.10, 95% CI: 1.67-10.10, P=0.002), were risk factors for postoperative organ/space SSI. The number of risk factors was significantly associated with an increased risk of organ/space SSI (P<0.001), which was 2.8% in patients with 0-1 risk factor (RR=0.20, 95% CI: 0.11-0.35), 13.0% in patients with 2 risk factors (RR=3.64, 95% CI: 2.14-6.20) and 35.7% in patients with 3 risk factors (RR=6.41, 95% CI: 3.01-13.65).ConclusionThis study is a preliminary exploratory and provides a simple risk stratification to identify the risk of postoperative organ/space SSI for patients with advanced digestive system cancer. Further research is needed to validate and generalize the results in a wider population.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT02715076; Chinese Clinical Trial Registry [https://www.chictr.org.cn/enindex.aspx], identifier ChiCTR-IPR-17011099.
format	article
author	Chen Sun Hui Gao Yuelun Zhang Lijian Pei Lijian Pei Yuguang Huang
author_facet	Chen Sun Hui Gao Yuelun Zhang Lijian Pei Lijian Pei Yuguang Huang
author_sort	Chen Sun
title	Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer
title_short	Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer
title_full	Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer
title_fullStr	Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer
title_full_unstemmed	Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer
title_sort	risk stratification for organ/space surgical site infection in advanced digestive system cancer
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ce62cf926c744224bd525f502ab903c0
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Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer

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