Program Schedule

1016
Surgical Site Infection Risk Stratification for Kidney Surgery: Use of Endoscopy as an Effect Modifier

Session: Poster Abstract Session: Surgical Site Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • IDSA 2014 Poster_Yamagishi.pdf (651.0 kB)
  • Background:  Risk factors of surgical site infection (SSI) for kidney surgery have not been determined yet because the number of procedures is not enough. To estimate the risk and find the risk factors of SSI for kidney surgery, the Japan Nosocomial Infections Surveillance (JANIS) SSI division, which is a voluntary based, national-level surveillance in Japan, was analyzed.

    Methods:  Logistic regression analysis using data on kidney surgery in the JANIS SSI division database from January 1, 2008 to December 31, 2010, was conducted separately for procedures with and without the use of endoscopy.

    Results:  A total of 1819 procedures of kidney surgery were analyzed. Twelve cases of SSI occurred in 837 endoscopic surgeries (1.4%), and 17 cases of SSI occurred in 982 open surgeries (1.7%). Associations between SSI incidence and age, wound class, and American Society of Anesthesiology (ASA) score differed according to whether endoscopy was used. For endoscopic surgery, age (adjusted odds ratio (AOR), 1.07 [95 percent confidence interval (95% CI), 1.00–1.14]; P = 0.04) and duration of surgery (AOR, 1.01 [95% CI, 1.00–1.01]; P = 0.02) were associated with SSI. For open surgery, wound class other than clean (AOR, 4.82 [95% CI, 1.07–21.59]; P = 0.01) and ASA score ≥3 (AOR, 4.28 [95% CI, 1.51–12.15]; P=0.01) were associated with SSI.

    Conclusion:  Since the risk factors for SSI differed between endoscopic and open kidney surgery, they should be analyzed separately when predicting the risk of SSI.

    Table  Logistic regression analysis of factors associated with surgical site infection with kidney surgery, JANIS, 2008–2010

    Risk factor

    Endoscopic surgery (n = 837)

    Open surgery (n = 982)

    AOR

    95%CI

    P value

    AOR

    95%CI

    P value

    Age

    1.07

    1.00–1.14

    0.04

    0.99

    0.96–1.02

    0.47

    Sex

       Male

    ref.

    ref.

       Female

    0.69

    0.18–2.66

    0.59

    1.00

    0.35–2.83

    1.00

    Wound class

       C

    ref.

    ref.

       CC, CO, or D

    0.68

    0.20–2.30

    0.54

    4.82

    1.07–21.59

    0.04

    ASA score

       1, 2

    ref.

    ref.

       3, 4, 5

    2.06

    0.53–8.05

    0.30

    4.28

    1.51–12.15

    0.01

    Duration of surgery

    1.01

    1.00–1.01

    0.02

    1.00

    1.00–1.01

    0.06

    Combined surgery

       No

    ref.

    ref.

       Yes

    1.38

    0.26–7.28

    0.71

    2.12

    0.53–8.53

    0.29

    NOTE.  AOR, Adjusted odds ratio; ASA, American Society of Anesthesiology; JANIS, Japan Nosocomial Infections Surveillance; 95%CI: 95 percent confidence interval; C: clean, CC: clean-contaminated, CO: contaminated, D: dirty.

    Takuya Yamagishi, MD, PhD1, Satowa Suzuki, MD, PhD2, Mayumi Aminaka, RN, PhD3, Atsuko Tsutsui, MD, PhD2, Keita Morikane, MD, PhD4 and Keigo Shibayama, MD, PhD5, (1)Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan, (2)National Institute of Infectious Diseases, Tokyo, Japan, (3)National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan, (4)Infection Control, Yamagata University Hospital, Yamagata, Japan, (5)Department of Bacteriology II, Natl. Inst. of Infectious Diseases, Musashi-Murayama, Tokyo, Japan

    Disclosures:

    T. Yamagishi, None

    S. Suzuki, None

    M. Aminaka, None

    A. Tsutsui, None

    K. Morikane, None

    K. Shibayama, None

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