Schwartz et al identified risk factors for surgical site infection following laryngectomy. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Washington Seattle, VA Puget Sound Health Care System, Tenet Health System (Dallas), University of Colorado, VA Boston Healthcare System and Brigham and Women's Hospital.
Patient selection: laryngectomy
Outcome: surgical site infection (SSI), with overall rate 10%
Risk factors for an SSI:
(1) prolonged operative time (> 10 hours; OR 2.1)
(2) low serum albumin (< 3.7 g/dL; OR 1.9)
(3) diabetes mellitus (OR 1.78)
(4) preoperative radiation (OR 1.63)
(5) hematocrit < 35% (OR 1.59)
(6) platelet count > 300,000 per microliter (OR 1.48)
If the first 3 risk factors are examined:
Risk Factors
Rate of SSI
none
6.3%
low serum albumin and/or preoperative radiation therapy
13.7%
(low serum albumin and/or preoperative radiation therapy) AND diabetes
21.7%
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