Risk of surgical site infection (SSI) following colorectal resection is higher in patients with disseminated cancer

An NCCN member cohort study

Mini Kamboj, Teresa Childers, Jessica Sugalski, Donna Antonelli, Juliane Bingener-Casey, Jamie Cannon, Karie Cluff, Kimberly A. Davis, E. Patchen Dellinger, Sean C. Dowdy, Kim Duncan, Julie Fedderson, Robert Glasgow, Bruce Hall, Marilyn Hirsch, Matthew Hutter, Lisa Kimbro, Boris Kuvshinoff, Martin A Makary, Melanie Morris & 10 others Sharon Nehring, Sonia Ramamoorthy, Rebekah Scott, Mindy Sovel, Vivian Strong, Ashley Webster, Elizabeth Wick, Julio Garcia Aguilar, Robert Carlson, Kent Sepkowitz

Research output: Contribution to journalArticle

Abstract

BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRSDESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.SETTING Multicenter studyPARTICIPANTS Of 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.MAIN OUTCOME The primary outcome of interest was 30-day SSI rate.RESULTS A total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23-2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09-1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06-2.53; P=.02), and longer duration of procedure were associated with development of SSI.CONCLUSIONS Patients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes. Infect Control Hosp Epidemiol 2018;39:555-562

Original languageEnglish (US)
Pages (from-to)555-562
Number of pages8
JournalInfection Control and Hospital Epidemiology
Volume39
Issue number5
DOIs
StatePublished - May 1 2018

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Surgical Wound Infection
Cohort Studies
Neoplasms
Chronic Obstructive Pulmonary Disease
Colorectal Surgery
Odds Ratio
International Classification of Diseases
Confidence Intervals
Quality Improvement
Information Storage and Retrieval
Centers for Disease Control and Prevention (U.S.)
Cross Infection

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Risk of surgical site infection (SSI) following colorectal resection is higher in patients with disseminated cancer : An NCCN member cohort study. / Kamboj, Mini; Childers, Teresa; Sugalski, Jessica; Antonelli, Donna; Bingener-Casey, Juliane; Cannon, Jamie; Cluff, Karie; Davis, Kimberly A.; Dellinger, E. Patchen; Dowdy, Sean C.; Duncan, Kim; Fedderson, Julie; Glasgow, Robert; Hall, Bruce; Hirsch, Marilyn; Hutter, Matthew; Kimbro, Lisa; Kuvshinoff, Boris; Makary, Martin A; Morris, Melanie; Nehring, Sharon; Ramamoorthy, Sonia; Scott, Rebekah; Sovel, Mindy; Strong, Vivian; Webster, Ashley; Wick, Elizabeth; Aguilar, Julio Garcia; Carlson, Robert; Sepkowitz, Kent.

In: Infection Control and Hospital Epidemiology, Vol. 39, No. 5, 01.05.2018, p. 555-562.

Research output: Contribution to journalArticle

Kamboj, M, Childers, T, Sugalski, J, Antonelli, D, Bingener-Casey, J, Cannon, J, Cluff, K, Davis, KA, Dellinger, EP, Dowdy, SC, Duncan, K, Fedderson, J, Glasgow, R, Hall, B, Hirsch, M, Hutter, M, Kimbro, L, Kuvshinoff, B, Makary, MA, Morris, M, Nehring, S, Ramamoorthy, S, Scott, R, Sovel, M, Strong, V, Webster, A, Wick, E, Aguilar, JG, Carlson, R & Sepkowitz, K 2018, 'Risk of surgical site infection (SSI) following colorectal resection is higher in patients with disseminated cancer: An NCCN member cohort study', Infection Control and Hospital Epidemiology, vol. 39, no. 5, pp. 555-562. https://doi.org/10.1017/ice.2018.40
Kamboj, Mini ; Childers, Teresa ; Sugalski, Jessica ; Antonelli, Donna ; Bingener-Casey, Juliane ; Cannon, Jamie ; Cluff, Karie ; Davis, Kimberly A. ; Dellinger, E. Patchen ; Dowdy, Sean C. ; Duncan, Kim ; Fedderson, Julie ; Glasgow, Robert ; Hall, Bruce ; Hirsch, Marilyn ; Hutter, Matthew ; Kimbro, Lisa ; Kuvshinoff, Boris ; Makary, Martin A ; Morris, Melanie ; Nehring, Sharon ; Ramamoorthy, Sonia ; Scott, Rebekah ; Sovel, Mindy ; Strong, Vivian ; Webster, Ashley ; Wick, Elizabeth ; Aguilar, Julio Garcia ; Carlson, Robert ; Sepkowitz, Kent. / Risk of surgical site infection (SSI) following colorectal resection is higher in patients with disseminated cancer : An NCCN member cohort study. In: Infection Control and Hospital Epidemiology. 2018 ; Vol. 39, No. 5. pp. 555-562.
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abstract = "BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRSDESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.SETTING Multicenter studyPARTICIPANTS Of 22 invited NCCN centers, 11 participated (50{\%}). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.MAIN OUTCOME The primary outcome of interest was 30-day SSI rate.RESULTS A total of 652 SSIs (11.06{\%}) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5{\%}; odds ratio [OR], 1.66; 95{\%} confidence interval [CI], 1.23-2.26; P=.001), ASA score ≥3 (OR, 1.41; 95{\%} CI, 1.09-1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95{\%} CI, 1.06-2.53; P=.02), and longer duration of procedure were associated with development of SSI.CONCLUSIONS Patients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes. Infect Control Hosp Epidemiol 2018;39:555-562",
author = "Mini Kamboj and Teresa Childers and Jessica Sugalski and Donna Antonelli and Juliane Bingener-Casey and Jamie Cannon and Karie Cluff and Davis, {Kimberly A.} and Dellinger, {E. Patchen} and Dowdy, {Sean C.} and Kim Duncan and Julie Fedderson and Robert Glasgow and Bruce Hall and Marilyn Hirsch and Matthew Hutter and Lisa Kimbro and Boris Kuvshinoff and Makary, {Martin A} and Melanie Morris and Sharon Nehring and Sonia Ramamoorthy and Rebekah Scott and Mindy Sovel and Vivian Strong and Ashley Webster and Elizabeth Wick and Aguilar, {Julio Garcia} and Robert Carlson and Kent Sepkowitz",
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T1 - Risk of surgical site infection (SSI) following colorectal resection is higher in patients with disseminated cancer

T2 - An NCCN member cohort study

AU - Kamboj, Mini

AU - Childers, Teresa

AU - Sugalski, Jessica

AU - Antonelli, Donna

AU - Bingener-Casey, Juliane

AU - Cannon, Jamie

AU - Cluff, Karie

AU - Davis, Kimberly A.

AU - Dellinger, E. Patchen

AU - Dowdy, Sean C.

AU - Duncan, Kim

AU - Fedderson, Julie

AU - Glasgow, Robert

AU - Hall, Bruce

AU - Hirsch, Marilyn

AU - Hutter, Matthew

AU - Kimbro, Lisa

AU - Kuvshinoff, Boris

AU - Makary, Martin A

AU - Morris, Melanie

AU - Nehring, Sharon

AU - Ramamoorthy, Sonia

AU - Scott, Rebekah

AU - Sovel, Mindy

AU - Strong, Vivian

AU - Webster, Ashley

AU - Wick, Elizabeth

AU - Aguilar, Julio Garcia

AU - Carlson, Robert

AU - Sepkowitz, Kent

PY - 2018/5/1

Y1 - 2018/5/1

N2 - BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRSDESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.SETTING Multicenter studyPARTICIPANTS Of 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.MAIN OUTCOME The primary outcome of interest was 30-day SSI rate.RESULTS A total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23-2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09-1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06-2.53; P=.02), and longer duration of procedure were associated with development of SSI.CONCLUSIONS Patients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes. Infect Control Hosp Epidemiol 2018;39:555-562

AB - BACKGROUND Surgical site infections (SSIs) following colorectal surgery (CRS) are among the most common healthcare-associated infections (HAIs). Reduction in colorectal SSI rates is an important goal for surgical quality improvement.OBJECTIVE To examine rates of SSI in patients with and without cancer and to identify potential predictors of SSI risk following CRSDESIGN American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data files for 2011-2013 from a sample of 12 National Comprehensive Cancer Network (NCCN) member institutions were combined. Pooled SSI rates for colorectal procedures were calculated and risk was evaluated. The independent importance of potential risk factors was assessed using logistic regression.SETTING Multicenter studyPARTICIPANTS Of 22 invited NCCN centers, 11 participated (50%). Colorectal procedures were selected by principal procedure current procedural technology (CPT) code. Cancer was defined by International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes.MAIN OUTCOME The primary outcome of interest was 30-day SSI rate.RESULTS A total of 652 SSIs (11.06%) were reported among 5,893 CRSs. Risk of SSI was similar for patients with and without cancer. Among CRS patients with underlying cancer, disseminated cancer (SSI rate, 17.5%; odds ratio [OR], 1.66; 95% confidence interval [CI], 1.23-2.26; P=.001), ASA score ≥3 (OR, 1.41; 95% CI, 1.09-1.83; P=.001), chronic obstructive pulmonary disease (COPD; OR, 1.6; 95% CI, 1.06-2.53; P=.02), and longer duration of procedure were associated with development of SSI.CONCLUSIONS Patients with disseminated cancer are at a higher risk for developing SSI. ASA score >3, COPD, and longer duration of surgery predict SSI risk. Disseminated cancer should be further evaluated by the Centers for Disease Control and Prevention (CDC) in generating risk-adjusted outcomes. Infect Control Hosp Epidemiol 2018;39:555-562

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