524. Risk Factors for Development of Surgical Site Infection (SSI) Following Renal Transplantation
Session: Poster Abstract Session: Surgical Site Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background: Surgical site infections (SSI) are associated with significant morbidity, mortality and healthcare cost. Few studies have examined risk factors for development of SSI among renal transplant recipients. 

Methods: We performed a retrospective cohort study of adult renal transplant recipients at the University of Maryland Medical Center from January 2010 to December 2011 to identify risk factors for SSI. The primary outcome (SSI) was identified by reviewing patient medical records using defined criteria by the National Healthcare Safety Network (NHSN). Additional data (demographic and risk factors) were collected by chart review and an electronic data repository. The Chi-square and t-test were used to compare categorical and continuous variables respectively.  Risk factors for SSI were identified by multiple logistic regression. 

Results:

441 patients underwent renal transplantation during the study period. The mean age was 53 years; 58% (256/441) were men; 47%(207/441) were African American and 48% (210/441) were white. 71% (315/441) of organs transplanted were cadaveric. 15% (66/441) of patients developed SSI; 47% (31/66) “superficial” and 53% (35/66) “deep”. 50% (220/441) were re-admitted within 30 days of transplantation; 94% (62/66) of cases and 42% (158/375) of controls (p<0.01).  The table below outlines results of bi-variate analyses that were included in multivariate analysis. In the multivariate analysis only BMI was associated with the development of SSI (OR 1.07, 95% CI 1.02-1.11)

 Study Variables*

Entire Cohort (N=441)

Cases (N=66)

Controls (N=375)

p-value

BMI

29.7 (5.9)

31.7 (5.7)

29.4 (5.9)

<0.01

Surgery duration (hr)

3.2 (1.1)

3.2 (1.0)

3.3 (1.2)

0.58

NHSN Score

2.1 (0.5)

2.1 (0.5)

2.1 (0.5)

0.95

Charlson Components

 

 

 

 

     Cerebrovascular

20 (4.5)

0

20 (58)

0.06

     Peripheral vascular

29 (6.6)

8 (12)

21 (5.6)

0.05

     Rheumatologic

20 (4.5)

6 (9)

14 (3.7)

0.05

*Continuous variables (BMI, Duration) reported as mean (SD); other variables are categorical & reported as number (%)

Conclusion: Obesity was strongly associated with development of SSI among renal transplant recipients. NHSN Score was not associated with development of SSI.  More research is needed to identify additional measures to be used in case-mix adjustment when comparing SSI rates between facilities.

Brandon Flemming, BS1, Kerri A. Thom, MD, MS2, Clare Rock, MD3, Michele Emerick, BSN, RN, CIC3, Michelle Harris Williams, BSN, RN, MSN, CIC3, Grace Nkonge, MT, MPH3, Jonathon Bromberg, MD, PhD4 and Anthony D. Harris, MD, MPH2, (1)Univeristy of Maryland School of Pharmacy, Baltimore, MD, (2)Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, (3)University of Maryland Medical Center, Baltimore, MD, (4)Division of Transplantation, University of Maryland Medical Center, Baltimore, MD

Disclosures:

B. Flemming, None

K. A. Thom, None

C. Rock, None

M. Emerick, None

M. Harris Williams, None

G. Nkonge, None

J. Bromberg, None

A. D. Harris, None

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