1457. Rates of Surgical Site Infection after Colon Surgery: A Comparison of Outcomes Using a Laparoscopic Approach Compared to Open Operations
Session: Poster Abstract Session: HAI: Surgical Site Infections
Friday, October 28, 2016
Room: Poster Hall
Posters
  • ID week Poster 1457.pdf (1.1 MB)
  • Background: Using laparoscopic approach results in shorter hospitalization, less blood loss, and earlier return of bowel function in patients undergoing colon surgery. However, the impact of laparoscopic approach for colon surgery on rates of surgical site infection (SSI) has not been adequately studied.

    Methods: We analyzed data from 24 hospitals in the DICON surgical database in order to identify all patients who underwent colon (COLO) surgical procedures in 2015. ICD-9/ICD-10 procedure codes were used to determine whether these patients had open procedures or laparoscopic procedures. SSI was defined using NHSN definitions. Additional data collected on all patient undergoing colon surgery included the following: age; preoperative glucose level; ASA score; wound class; operation time. Large volume hospitals were defined as hospitals at which >100 COLO procedures were performed in 2015.

    Results:

    • A total 2307 COLO procedures were performed in 2015: 956(41.4%) procedures were done by laparoscopic approach and 1348 (58.6%) by open technique. A total of 73 SSIs occurred in the entire cohort (SSI rate=3.2%). The rate of SSI was lower in the laparoscopic group (n=25, 2.6%) compared to the open group (n=48, 3.6%), but this difference was not statistically significant (RR 0.82, 95%CI 0.60-1.13, p=0.20). The median operative times were similar between the two groups. However operative durations were longer in both groups among patients with SSI (laparoscopic group: 159 min vs 140 min, p=0.13; open group: 154 min vs 126 min, p<0.01). Organ/space SSIs (12/25, 48.0%) were common in laparoscopic group, while superficial incisional SSIs (23/48, 47.9%) were common in open group. The most common isolates from SSIs were E. coli in both laparoscopic and open group (24.0% and 18.8% respectively). Large volume hospitals had lower rates of SSI than small volume hospitals. The risk of SSI was 3.4-fold higher in small volume hospitals (RR=3.39, 95%CI 1.96-5.84, p<0.001).

    Conclusion: Rates of SSI were similar in patients with laparoscopic COLO approach compared to open procedure. Of note, high volume hospitals had lower rates of SSI than small volume hospitals. Thus, hospitals looking to determine expected rate of SSI should account for surgical volume in their calculations.

    Maojun Ge, PhD1, Sarah S. Lewis, MD MPH2, Rebekah W. Moehring, MD, MPH2, Daniel J. Sexton, MD, FIDSA, FSHEA2 and Deverick Anderson, MD, MPH, FIDSA, FSHEA2, (1)Department of Medicine, Department of medicine, division of infectious disease, Duke University Medical Center, Durham, NC, (2)Division of Infectious Diseases, Duke University Medical Center, Durham, NC

    Disclosures:

    M. Ge, None

    S. S. Lewis, None

    R. W. Moehring, None

    D. J. Sexton, None

    D. Anderson, None

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