Incidence and risk factors for incisional surgical site infection in patients with Crohn’s disease undergoing bowel resection  

作　　者：Tuo Hu Xianrui Wu Jiancong Hu Yufeng Chen Huashan Liu Chi Zhou Xiaowen He Min Zhi Xiaojian Wu Ping Lan 

机构地区：[1]Department of Colorectal Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,China [2]Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,Guangdong Institute of Gastroenterology,Guangzhou,Guangdong,China [3]Department of Gastroenterology/Hepatology,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,China

出　　处：《Gastroenterology Report》2018年第3期189-194,共6页胃肠病学报道（英文）

基　　金：supported by the National Natural Science Foundation of China(No.81400603);the Guangdong Natural Science Foundation(No.2015A030310190);the Science and Technology Planning Project of Guangdong Province(No.2015B020229001).

摘　　要：Background:Patients with Crohn’s disease(CD)are often reported to be at a high risk for incisional surgical site infection(SSI).The aim of this study was to identify the risk factors associated with post-operative incisional SSI in CD patients after bowel resection.Method:CD patients undergoing bowel resection between 2007 and 2015 were enrolled.Demographic and clinical features related to post-operative incisional SSI were analysed using both univariate and multivariate logistical analyses.Results:Of all eligible patients(n=159),123(77.4%)were male,with a mean age at surgery of 33.4611.8 years.A total of 35(22.0%)CD patients developed post-operative incisional SSI.Post-operative incisional SSI was more likely to happen in patients who had penetrating type of disease(P=0.018),underwent bowel resection for the indication of chronic fistula(P=0.005)and had an intra-operative finding of fistula(P=0.001).A greater proportion of patients with post-operative incisional SSI were found to have anemia(P=0.019)but elevated levels of white blood cells(P=0.027),neutrophils(P=0.006)as well as an elevated percentage of neutrophils(P=0.005).Multivariate logistic regression analysis showed that anemia(odds ratio[OR]:3.31,95%confidence interval[CI]:1.05-10.46,P=0.041),an elevated percentage of neutrophils(OR:2.85,95%CI:1.23-6.59,P=0.014)and an intra-operative finding of fistula(OR:3.76,95%CI:1.53-9.21,P=0.004)were significantly associated with the risk for post-operative incisional SSI.Conclusions:Anemia,elevated percentage of neutrophils and intra-operative finding of fistula are predictors for the development of post-operative incisional SSI in CD patients undergoing bowel resection.Favorable pre-operative nutrition status and low inflammatory status may lessen the incidence of post-operative incisional SSI.

关 键 词：Crohn’s disease incisional surgical site infection risk factors bowel resection 

分 类 号：R57[医药卫生—消化系统]