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A Nested Case–Control Study on the Risk of Surgical Site Infection After Thyroid Surgery

Salem, F. A. LU ; Almquist, M. LU ; Nordenström, E. LU ; Dahlberg, J. LU ; Hessman, O.; Lundgren, C. I. LU and Bergenfelz, A. LU (2018) In World Journal of Surgery p.1-8
Abstract

Introduction: It is unclear if antibiotic prophylaxis reduces the risk of surgical site infection (SSI) in thyroid surgery. This study assessed risk factors for SSI and antibiotic prophylaxis in subgroups of patients. Method and design: A nested case–control study on patients registered in the Swedish National Register for Endocrine Surgery was performed. Patients with SSI were matched 1:1 by age and gender to controls. Additional information on patients with SSI and controls was queried from attending surgeons using a questionnaire. Risk factors for SSI were evaluated by logistic regression analysis and presented as odds ratio (OR) with 95% confidence interval (CI). Results: There were 9494 operations; 109 (1.2%) patients had SSI.... (More)

Introduction: It is unclear if antibiotic prophylaxis reduces the risk of surgical site infection (SSI) in thyroid surgery. This study assessed risk factors for SSI and antibiotic prophylaxis in subgroups of patients. Method and design: A nested case–control study on patients registered in the Swedish National Register for Endocrine Surgery was performed. Patients with SSI were matched 1:1 by age and gender to controls. Additional information on patients with SSI and controls was queried from attending surgeons using a questionnaire. Risk factors for SSI were evaluated by logistic regression analysis and presented as odds ratio (OR) with 95% confidence interval (CI). Results: There were 9494 operations; 109 (1.2%) patients had SSI. Patients with SSI were older (median 53 vs. 49 years) than patients without SSI p = 0.01 and more often had a cancer diagnosis 23 (21.1%) versus 1137 (12.1%) p = 0.01. In the analysis of patients with SSI versus controls, patients with SSI more often had post-operative drainage 68 (62.4%) versus 46 (42.2%) p = 0.01 and lymph node surgery 40 (36.7%) versus 14 (13.0%) p < 0.01, and both were independent risk factors for SSI, drain OR 1.82 (CI 1.04–3.18) and lymph node dissection, OR 3.22 (95% CI 1.32–7.82). A higher number of 26(62%) patients with independent risk factors for SSI and diagnosed with SSI did not receive antibiotic prophylaxis. Data were missing for 8 (31%) patients. Conclusion: Lymph node dissection and drain are independent risk factors for SSI after thyroidectomy. Antibiotic prophylaxis might be considered in patients with these risk factors.

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author
organization
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type
Contribution to journal
publication status
in press
subject
in
World Journal of Surgery
pages
1 - 8
publisher
Springer
external identifiers
  • scopus:85042389689
ISSN
0364-2313
DOI
10.1007/s00268-018-4492-2
language
English
LU publication?
yes
id
d69ebf8c-ca96-4b8b-b36b-37b50bdf7512
date added to LUP
2018-03-08 15:54:09
date last changed
2018-12-09 04:37:41
@article{d69ebf8c-ca96-4b8b-b36b-37b50bdf7512,
  abstract     = {<p>Introduction: It is unclear if antibiotic prophylaxis reduces the risk of surgical site infection (SSI) in thyroid surgery. This study assessed risk factors for SSI and antibiotic prophylaxis in subgroups of patients. Method and design: A nested case–control study on patients registered in the Swedish National Register for Endocrine Surgery was performed. Patients with SSI were matched 1:1 by age and gender to controls. Additional information on patients with SSI and controls was queried from attending surgeons using a questionnaire. Risk factors for SSI were evaluated by logistic regression analysis and presented as odds ratio (OR) with 95% confidence interval (CI). Results: There were 9494 operations; 109 (1.2%) patients had SSI. Patients with SSI were older (median 53 vs. 49 years) than patients without SSI p = 0.01 and more often had a cancer diagnosis 23 (21.1%) versus 1137 (12.1%) p = 0.01. In the analysis of patients with SSI versus controls, patients with SSI more often had post-operative drainage 68 (62.4%) versus 46 (42.2%) p = 0.01 and lymph node surgery 40 (36.7%) versus 14 (13.0%) p &lt; 0.01, and both were independent risk factors for SSI, drain OR 1.82 (CI 1.04–3.18) and lymph node dissection, OR 3.22 (95% CI 1.32–7.82). A higher number of 26(62%) patients with independent risk factors for SSI and diagnosed with SSI did not receive antibiotic prophylaxis. Data were missing for 8 (31%) patients. Conclusion: Lymph node dissection and drain are independent risk factors for SSI after thyroidectomy. Antibiotic prophylaxis might be considered in patients with these risk factors.</p>},
  author       = {Salem, F. A. and Almquist, M. and Nordenström, E. and Dahlberg, J. and Hessman, O. and Lundgren, C. I. and Bergenfelz, A.},
  issn         = {0364-2313},
  language     = {eng},
  month        = {02},
  pages        = {1--8},
  publisher    = {Springer},
  series       = {World Journal of Surgery},
  title        = {A Nested Case–Control Study on the Risk of Surgical Site Infection After Thyroid Surgery},
  url          = {http://dx.doi.org/10.1007/s00268-018-4492-2},
  year         = {2018},
}