Study identifies SSI risk factors after open LEB

 

COLUMBUS, OHIO – A study of vascular procedures at 35 Michigan hospitals has identified three risk factors for surgical site infection after lower-extremity bypass that hospitals and vascular surgery teams may be able to modify.

“Patients who had iodine-only skin antiseptic preparation, a high-peak intraoperative glucose, or long operative times were more likely to have substantially increased risk for surgical site infection (SSI),” Frank Davis, MD, of the University of Michigan said in reporting the study results at the annual meeting of the Midwestern Vascular Surgical Society. Those risk factors are modifiable, Dr. Davis said.

The study collected data on 3,992 patients who had elective or urgent open lower-extremity bypass at 35 hospitals participating in the Blue Cross Blue Shield Michigan Vascular Intervention Collaborative from January 2012 to June 2015. The goal of the study was to understand not only patient and procedural risk factors that could lead to SSI in these operations, but also to determine how hospital structural and process-of-care characteristics may contribute to SSI risk, Dr. Davis said. The primary outcome of the study was SSI within 30 days of the index operation.

“Specific attention needs to be served moving forward in attempts to decrease the risk of SSI for lower-extremity bypass,” Dr. Davis said. “The incidence of SSI in our cohort across the state of Michigan was approximately 9.2%, and for those who did develop a SSI, there was a substantial increase in 30-day morbidity.”

Patients who had an SSI were more than three times more likely to have a major amputation (9% vs. 2.3%) than those without, and more than five times more likely to have a reoperation (3.9% vs. 0.7%), Dr. Davis said.

“With regard to preoperative symptomatology, those with lower peripheral artery questionnaire scores, resting pain, or acute ischemia were more likely to develop SSI postoperatively,” Dr. Davis said. “Patients who underwent an interim coronal bypass had a significant increase of SSI in comparison to all other bypass configurations.”

He also noted that major teaching hospitals or hospitals with 500 or fewer beds had higher rates of SSI.

“Targeted improvements in preoperative care may decrease complications and improve vascular patient outcomes,” Dr. Davis said.

Dr. Davis had no relationships to disclose.
 

 

COLUMBUS, OHIO – A study of vascular procedures at 35 Michigan hospitals has identified three risk factors for surgical site infection after lower-extremity bypass that hospitals and vascular surgery teams may be able to modify.

“Patients who had iodine-only skin antiseptic preparation, a high-peak intraoperative glucose, or long operative times were more likely to have substantially increased risk for surgical site infection (SSI),” Frank Davis, MD, of the University of Michigan said in reporting the study results at the annual meeting of the Midwestern Vascular Surgical Society. Those risk factors are modifiable, Dr. Davis said.

The study collected data on 3,992 patients who had elective or urgent open lower-extremity bypass at 35 hospitals participating in the Blue Cross Blue Shield Michigan Vascular Intervention Collaborative from January 2012 to June 2015. The goal of the study was to understand not only patient and procedural risk factors that could lead to SSI in these operations, but also to determine how hospital structural and process-of-care characteristics may contribute to SSI risk, Dr. Davis said. The primary outcome of the study was SSI within 30 days of the index operation.

“Specific attention needs to be served moving forward in attempts to decrease the risk of SSI for lower-extremity bypass,” Dr. Davis said. “The incidence of SSI in our cohort across the state of Michigan was approximately 9.2%, and for those who did develop a SSI, there was a substantial increase in 30-day morbidity.”

Patients who had an SSI were more than three times more likely to have a major amputation (9% vs. 2.3%) than those without, and more than five times more likely to have a reoperation (3.9% vs. 0.7%), Dr. Davis said.

“With regard to preoperative symptomatology, those with lower peripheral artery questionnaire scores, resting pain, or acute ischemia were more likely to develop SSI postoperatively,” Dr. Davis said. “Patients who underwent an interim coronal bypass had a significant increase of SSI in comparison to all other bypass configurations.”

He also noted that major teaching hospitals or hospitals with 500 or fewer beds had higher rates of SSI.

“Targeted improvements in preoperative care may decrease complications and improve vascular patient outcomes,” Dr. Davis said.

Dr. Davis had no relationships to disclose.
 

 

COLUMBUS, OHIO – A study of vascular procedures at 35 Michigan hospitals has identified three risk factors for surgical site infection after lower-extremity bypass that hospitals and vascular surgery teams may be able to modify.

“Patients who had iodine-only skin antiseptic preparation, a high-peak intraoperative glucose, or long operative times were more likely to have substantially increased risk for surgical site infection (SSI),” Frank Davis, MD, of the University of Michigan said in reporting the study results at the annual meeting of the Midwestern Vascular Surgical Society. Those risk factors are modifiable, Dr. Davis said.

The study collected data on 3,992 patients who had elective or urgent open lower-extremity bypass at 35 hospitals participating in the Blue Cross Blue Shield Michigan Vascular Intervention Collaborative from January 2012 to June 2015. The goal of the study was to understand not only patient and procedural risk factors that could lead to SSI in these operations, but also to determine how hospital structural and process-of-care characteristics may contribute to SSI risk, Dr. Davis said. The primary outcome of the study was SSI within 30 days of the index operation.

“Specific attention needs to be served moving forward in attempts to decrease the risk of SSI for lower-extremity bypass,” Dr. Davis said. “The incidence of SSI in our cohort across the state of Michigan was approximately 9.2%, and for those who did develop a SSI, there was a substantial increase in 30-day morbidity.”

Patients who had an SSI were more than three times more likely to have a major amputation (9% vs. 2.3%) than those without, and more than five times more likely to have a reoperation (3.9% vs. 0.7%), Dr. Davis said.

“With regard to preoperative symptomatology, those with lower peripheral artery questionnaire scores, resting pain, or acute ischemia were more likely to develop SSI postoperatively,” Dr. Davis said. “Patients who underwent an interim coronal bypass had a significant increase of SSI in comparison to all other bypass configurations.”

He also noted that major teaching hospitals or hospitals with 500 or fewer beds had higher rates of SSI.

“Targeted improvements in preoperative care may decrease complications and improve vascular patient outcomes,” Dr. Davis said.

Dr. Davis had no relationships to disclose.