Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic Surgery

Background. The present study aimed to evaluate a potential effect of ERAS on surgical site infections (SSI). Methods. Colonic surgical patients operated between May 2011 and September 2015 constituted the cohort for this retrospective analysis. Over 100 items related to demographics, surgical detai...

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Main Authors: Caroline Gronnier, Fabian Grass, Christiane Petignat, Basile Pache, Dieter Hahnloser, Giorgio Zanetti, Nicolas Demartines, Martin Hübner
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2017/9015854
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author Caroline Gronnier
Fabian Grass
Christiane Petignat
Basile Pache
Dieter Hahnloser
Giorgio Zanetti
Nicolas Demartines
Martin Hübner
author_facet Caroline Gronnier
Fabian Grass
Christiane Petignat
Basile Pache
Dieter Hahnloser
Giorgio Zanetti
Nicolas Demartines
Martin Hübner
author_sort Caroline Gronnier
collection DOAJ
description Background. The present study aimed to evaluate a potential effect of ERAS on surgical site infections (SSI). Methods. Colonic surgical patients operated between May 2011 and September 2015 constituted the cohort for this retrospective analysis. Over 100 items related to demographics, surgical details, compliance, and outcome were retrieved from a prospectively maintained database. SSI were traced by an independent National surveillance program. Risk factors for SSI were identified by univariate and multinomial logistic regression. Results. Fifty-four out of 397 patients (14%) developed SSI. Independent risk factors for SSI were emergency surgery (OR 1.56; 95% CI 1.09–1.78, p=0.026), previous abdominal surgery (OR 1.7; 95% CI 1.32–1.87, p=0.004), smoking (OR 1.71; 95% CI 1.22–1.89, p=0.014), and oral bowel preparation (OR 1.86; 95% CI 1.34–1.97, p=0.013), while minimally invasive surgery (OR 0.3; 95% CI 0.16–0.56, p<0.001) protected against SSI. Compliance to ERAS items of >70% was not retained as a protective factor for SSI after multivariate analysis (OR 0.94; 95% CI 0.46–1.92, p=0.86). Conclusions. Smoking, open and emergency surgery, and bowel preparation were risk factors for SSI. ERAS pathway had no independent impact while minimally invasive approach did. This study was registered under ResearchRegistry.com (UIN researchregistry2614).
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spelling doaj-art-6a2a1afb24e14137a939255ad12aa55a2025-02-03T01:12:16ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/90158549015854Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic SurgeryCaroline Gronnier0Fabian Grass1Christiane Petignat2Basile Pache3Dieter Hahnloser4Giorgio Zanetti5Nicolas Demartines6Martin Hübner7Department of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandDepartment of Hospital Preventive Medicine, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandDepartment of Hospital Preventive Medicine, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandDepartment of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, SwitzerlandBackground. The present study aimed to evaluate a potential effect of ERAS on surgical site infections (SSI). Methods. Colonic surgical patients operated between May 2011 and September 2015 constituted the cohort for this retrospective analysis. Over 100 items related to demographics, surgical details, compliance, and outcome were retrieved from a prospectively maintained database. SSI were traced by an independent National surveillance program. Risk factors for SSI were identified by univariate and multinomial logistic regression. Results. Fifty-four out of 397 patients (14%) developed SSI. Independent risk factors for SSI were emergency surgery (OR 1.56; 95% CI 1.09–1.78, p=0.026), previous abdominal surgery (OR 1.7; 95% CI 1.32–1.87, p=0.004), smoking (OR 1.71; 95% CI 1.22–1.89, p=0.014), and oral bowel preparation (OR 1.86; 95% CI 1.34–1.97, p=0.013), while minimally invasive surgery (OR 0.3; 95% CI 0.16–0.56, p<0.001) protected against SSI. Compliance to ERAS items of >70% was not retained as a protective factor for SSI after multivariate analysis (OR 0.94; 95% CI 0.46–1.92, p=0.86). Conclusions. Smoking, open and emergency surgery, and bowel preparation were risk factors for SSI. ERAS pathway had no independent impact while minimally invasive approach did. This study was registered under ResearchRegistry.com (UIN researchregistry2614).http://dx.doi.org/10.1155/2017/9015854
spellingShingle Caroline Gronnier
Fabian Grass
Christiane Petignat
Basile Pache
Dieter Hahnloser
Giorgio Zanetti
Nicolas Demartines
Martin Hübner
Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic Surgery
Gastroenterology Research and Practice
title Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic Surgery
title_full Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic Surgery
title_fullStr Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic Surgery
title_full_unstemmed Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic Surgery
title_short Influence of Enhanced Recovery Pathway on Surgical Site Infection after Colonic Surgery
title_sort influence of enhanced recovery pathway on surgical site infection after colonic surgery
url http://dx.doi.org/10.1155/2017/9015854
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