Type of Pelvic Disease as a Risk Factor for Surgical Site Infectionin Women Undergoing Hysterectomy

Innie Chen, Abdul Jamil Choudhry, Choudhry AJ, David Schramm, D. William Cameron, Victor Leung, Leung V, Sukhbir S. Singh, Singh SS, Laura Hopkins, Hopkins L, Kristina Arendas, Arendas K, Ranjeeta Mallick, Mallick R
Journal of Minimally Invasive Gynecology · 2018 · vol. 26(6) , pp. 1149–1156 · doi:10.1016/j.jmig.2018.11.015 · PMID:30508651 · W2902090179
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This study investigated whether the type of pelvic disease impacts the risk of surgical site infection following hysterectomy in women.

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Abstract

Study objectiveTo quantify the relationship between type of benign pelvic disease and risk of surgical site infection (SSI) after hysterectomy.DesignRetrospective cohort study (Canadian Task Force classification II-2).SettingHospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP).PatientsWomen who underwent hysterectomy from 2006-2015 and recorded in NSQIP database.InterventionNone.Measurements and main resultsSSI risk was compared for type of benign pelvic disease, patient characteristics (i.e., age, race, and selected comorbidities) and process of care variables (i.e., admission status, type of hysterectomy, and operative time). SSI occurred in 2.48% of the 125,337 women who underwent hysterectomy. SSI was most frequent in patients with endometriosis and least frequent in those with genital prolapse (3.13% vs 1.39%; p <.0001). Following adjustment for potential confounders, the odds of SSI were higher in women undergoing hysterectomy for endometriosis (adjusted odds ratio [aOR], 1.79; 95% confidence interval [CI], 1.43- 2.25), uterine myomas (aOR, 1.28; 95% CI, 1.05-1.55), menstrual disorders (aOR, 1.46; 95% CI, 1.20-1.78), and pelvic pain (aOR, 1.75; 95% CI, 1.34-2.27) compared with women undergoing hysterectomy for genital prolapse. Other patient factors associated with SSI included age, body mass index, smoking, diabetes mellitus, chronic obstructive pulmonary disease, hypertension, and American Society of Anesthesiologists classification. Among process-of-care factors, inpatient status, route of hysterectomy, total vs subtotal hysterectomy, and operative time were also associated with SSI.ConclusionIn addition to various patient and process-of-care factors known to be associated with SSI, type of underlying pelvic disease is an independent risk factor for SSI in women undergoing hysterectomy for benign indications.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Genital Diseases, Female Genital Diseases, Female Hysterectomy Surgical Wound Infection Adult Body Mass Index Comorbidity Endometriosis Endometriosis Endometriosis Endometriosis Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Humans Hysterectomy Middle Aged Operative Time Pelvic Pain

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