J. E. Papin IV1,2, K. H. Sheetz1, D. A. Campbell1,2, M. J. Englesbe1,2 1University Of Michigan,Department Of Surgery,Ann Arbor, MI, USA 2Michigan Surgical Quality Collaborative,Ann Arbor, MI, USA
Introduction:
Following colectomy, the development of surgical site infections (SSI) and urinary tract infections (UTI) are common, morbid, and expensive. However, it is unclear to what extent associations between postoperative UTI and SSI affect patient outcomes. The purpose of this study was to determine whether post-operative UTI is an independent risk factor for subsequent SSI.
Methods:
Using data from the Michigan Surgical Quality Collaborative, we identified 30,727 patients undergoing colon resection within 73 hospitals between 2008 and 2015. We evaluated the independent effect of an initial postoperative UTI on the incidence of SSI using multivariate logistic regression adjusting for patient demographic, clinical, and case-specific Surgical Care Improvement Program (SCIP) process compliance.
Results:
In our study cohort, 1.2% of patients developed a postoperative UTI and 10.0% developed a postoperative SSI. Unadjusted rates of SSI were higher in patients with an initial post-operative UTI (22.7% v. 9.9% p<0.01). In multivariate models, post-operative UTI was an independent risk factor for the development of SSI (OR 3.35, 95% CI 2.50-4.48).
Conclusion:
Post-operative UTI is an independent risk factor for the development of SSI after colectomy. Though poorly characterized, quality improvement initiatives aiming to decrease the incidence of UTI may influence SSI rates following colectomy. These associations warrant further investigation and may allow for streamlining of practices designed to reduce postoperative infections.