Colorectal Surgery Complications Risk Factors | Medical Algorithm

Description

Tang et al identified risk factors for surgical site infection following elective resection of the colorectum. These can help to identify a patient who may require closer monitoring for complications. The authors are from Chang Gung Memorial Hospital in Linkou, Taiwan.

Patient selection: elective surgery

Parameters:

(1) ASA score

(2) gender

(3) type of operation

(4) surgeon

(5) ostomy creation

(6) wound contamination

(7) use of a drain

(8) blood transfusion during and after surgery

Parameter	Finding	OR
ASA score	1	1
	2 or 3	1.7
gender	female	1
	male	1.5
surgeon	low risk	1
	intermediate risk	2.4
	high risk	3.7
type of operation	abdominoperitoneal resection	1
	anterior resection	4.8
	segmental colectomy	4.4
	total or subtotal colectomy	9.5
	Harmann's operation	2.2
ostomy	not created	1
	created	2.1
wound	not contaminated	1
	contaminated	2.8
drain	not used	1
	used	1.6
blood transfusion	none	1
	1 to 3 units	2.0
	4 or more	6.2

where:

• A patient with an ASA score of 4 or 5 is unlikely to undergo an elective resection.

• The OR for surgeons is a simplification. The authors calculated an OR for each surgeon.

• The OR are from Table 3 page 186. Some of the numbers in the abstract are different.

cumulative odds ratio for SSI =

= PRODUCT(OR for all 8 risk factors)

Interpretation:

• minimum cumulative OR: 1

• maximum cumulative OR: over 5,000

Additional risk factors:

(1) operative time > 3 hours (for incisional SSI)

(2) failure to use prophylactic antibiotics

(3) hypoalbuminemia (for incisional SSI)

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Description

Specialty

Objective

ICD-10

Surgical Site Infection Risk Factors Following Elective Resection of Colon and/or Rectum

Purpose: To predict the cumulative odds ratio for a surgical site infection (SSI) for a patient undergoing elective colorectal resection as reported by Tang et al.

Description

Specialty

Objective

ICD-10