Obesity and the Risk for Surgical Site Infection in Abdominal Surgery

Robert D. Winfield, Stacey Reese, Kelly Bochicchio, John E. Mazuski, Grant V. Bochicchio

Research output: Contribution to journalArticle

Abstract

Obesity is a risk factor for surgical site infection (SSI) after abdominal procedures; however, data characterizing the risk of SSI in obese patients during abdominal procedures are lacking. We hypothesized that obesity is an independent risk factor for SSI across wound classes. We analyzed American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data for 2011. We calculated body mass index (BMI), classifying patients according to National Institute of Health (NIH) BMI groups. We excluded records in which height/weight was not recorded and patients with BMI less than 18.5. We examined patients undergoing open abdominal procedures, performing univariate and multivariate analyses to assess the relative contribution of obesity to SSI. Study criteria were met by 89,148 patients. Obese and morbidly obese patients had significantly greater SSI rates in clean and clean-contaminated cases but not contaminated or dirty/infected cases. Logistic regression confirmed obesity and morbid obesity as being independently associated with the overall SSI development, specifically in clean [Obesity odds ratio (OR) = 1.757, morbid obesity OR = 2.544, P < 0.001] and clean-contaminated (obesity OR = 1.239, morbid obesity OR = 1.287, P < 0.001) cases. Obesity is associated with increased risk of SSI overall, specifically in clean and clean-contaminated abdominal procedures; this is independent of diabetes mellitus. Novel techniques are needed to reduce SSI in this high-risk patient population.

Original languageEnglish (US)
Pages (from-to)331-336
Number of pages6
JournalAmerican Surgeon
Volume82
Issue number4
StatePublished - Apr 1 2016
Externally publishedYes

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Surgical Wound Infection
Obesity
Morbid Obesity
Odds Ratio
Body Mass Index
National Institutes of Health (U.S.)
Quality Improvement
Diabetes Mellitus
Multivariate Analysis
Logistic Models
Weights and Measures
Wounds and Injuries

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Winfield, R. D., Reese, S., Bochicchio, K., Mazuski, J. E., & Bochicchio, G. V. (2016). Obesity and the Risk for Surgical Site Infection in Abdominal Surgery. American Surgeon, 82(4), 331-336.

Obesity and the Risk for Surgical Site Infection in Abdominal Surgery. / Winfield, Robert D.; Reese, Stacey; Bochicchio, Kelly; Mazuski, John E.; Bochicchio, Grant V.

In: American Surgeon, Vol. 82, No. 4, 01.04.2016, p. 331-336.

Research output: Contribution to journalArticle

Winfield, RD, Reese, S, Bochicchio, K, Mazuski, JE & Bochicchio, GV 2016, 'Obesity and the Risk for Surgical Site Infection in Abdominal Surgery', American Surgeon, vol. 82, no. 4, pp. 331-336.
Winfield RD, Reese S, Bochicchio K, Mazuski JE, Bochicchio GV. Obesity and the Risk for Surgical Site Infection in Abdominal Surgery. American Surgeon. 2016 Apr 1;82(4):331-336.
Winfield, Robert D. ; Reese, Stacey ; Bochicchio, Kelly ; Mazuski, John E. ; Bochicchio, Grant V. / Obesity and the Risk for Surgical Site Infection in Abdominal Surgery. In: American Surgeon. 2016 ; Vol. 82, No. 4. pp. 331-336.
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