Abstract:
BACKGROUND AND PURPOSE:Each year, as many as two million operations are complicated by surgical site infections in the United States, and surgical patients account for 30% of patients with sepsis. The purpose of this study was to determine recent trends in sepsis incidence, severity, and mortality rate after surgical procedures and to evaluate changes in the pattern of septicemia pathogens over time. METHODS:Analysis of the 1990-2006 hospital discharge data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for New Jersey. Patients >or= 18 years who developed sepsis after surgery were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes as defined by the Patient Safety Indicator "Postoperative Sepsis" developed by the Agency for Healthcare Research and Quality (AHRQ). Severe sepsis was defined as sepsis complicated by organ dysfunction. RESULTS:A total of 1,276,451 surgery discharges (537,843 elective [42.1%] and 738,608 non-elective [57.9%] procedures) were identified. After elective surgery, 5,865 patients (1.09%) developed postoperative sepsis, of whom 2,778 (0.52%) had severe sepsis. The incidence of postoperative sepsis after elective surgery increased from 0.67% to 1.74% (p < 0.0001) and severe sepsis after elective surgery from 0.22% to 1.12% (p < 0.0001). The sepsis mortality rate for elective procedures showed no significant change over time. The proportion of severe sepsis after elective cases increased from 32.9% to 64.6% (p < 0.0002). The rates of postoperative sepsis (4.24%) and severe sepsis (2.28%) were significantly greater for non-elective than for elective procedures (p < 0.0002). Non-elective surgical procedures had a significant increase in the rates of postoperative sepsis (3.74% to 4.51%) and severe sepsis (1.79% to 3.15%) over time (p < 0.0001) with the proportion of severe sepsis increasing from 47.7% to 69.9% (p < 0.0002). The in-hospital mortality rate after non-elective surgery decreased from 37.9% to 29.8% (p < 0.0001). CONCLUSIONS:Sepsis and death were more likely after non-elective than elective surgery. Sepsis and severe sepsis has increased significantly after elective and non-elective procedures over the last 17 years. The hospital mortality rate was reduced significantly after non-elective surgery, but no improvements were found for elective surgery patients who developed sepsis. Disparities in age, sex, and ethnicity and the development of postoperative surgical sepsis were found. Population-based studies may assist in defining temporal trends, disparities, and outcomes in sepsis not elucidated in smaller studies.
journal_name
Surg Infect (Larchmt)journal_title
Surgical infectionsauthors
Vogel TR,Dombrovskiy VY,Lowry SFdoi
10.1089/sur.2008.046subject
Has Abstractpub_date
2009-02-01 00:00:00pages
71-8issue
1eissn
1096-2964issn
1557-8674journal_volume
10pub_type
杂志文章abstract:BACKGROUND:Primary echinococcosis, and especially primary alveolar echinococcosis (AE) is rare among adrenal lesions. METHODS:We report a case of primary AE in a 28-year-old male with low backache and occasional upper limb pain lasting for six months, and review the pertinent but sparse literature on this disorder. R...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2012.037
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:The designation "gram-positive bacillus" includes a variety of pleomorphic microorganisms, including diphtheroids, coryneform species, coccobacilli, and other small rods. Despite differing greatly in their virulence, sources, and even genus, these microscopically similar organisms are often difficult to diff...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2008.085
更新日期:2010-02-01 00:00:00
abstract:PURPOSE:To discover the incidence of postoperative surgical site infections in non-immunocompromised pediatric patients with an absolute neutrophil count (ANC) < or = 1,000 preoperatively. METHODS:Office and hospital charts of consecutive patients with preoperative ANC < or = 1,000 undergoing elective surgery over a t...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.085
更新日期:2008-04-01 00:00:00
abstract:: Background: Rates of infections with multi-drug-resistant organisms (MDROs) are increasing among critically ill patients. Among non-surgical patients, MDROs increase directly the risk of adverse secondary events including death. However, similar effects do not appear to oc...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.240
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Infection is the most common postoperative complication within the surgical wound and during severe trauma. In spite of the use of modern sterile techniques and prophylaxis, infection continues to be a leading cause of death in these patients. Therefore, it has become crucial to develop new alternatives to p...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.7.527
更新日期:2006-12-01 00:00:00
abstract:: Background: We aimed to assess independent risk factors for inadequate initial antimicrobial treatment (IAT) in critically ill patients with ventilator-associated pneumonia (VAP) treated in intensive care units (ICU) and to determine whether IAT is associated with adverse ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2020.306
更新日期:2021-01-13 00:00:00
abstract:BACKGROUND:In recent years, there has been a worldwide increase in infections caused by microorganisms resistant to multiple antimicrobial agents. METHODS:In the past few decades, an increased prevalence of infections caused by antibiotic-resistant pathogens, including Enterococcus spp., carbapenem-resistant Pseudomon...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2013.262
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Ceftaroline fosamil is a novel cephalosporin approved by the United States Food and Drug Administration (US FDA) for treatment of acute bacterial skin and skin structure infection, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). We evaluated the activity of ceftaroline and compa...
journal_title:Surgical infections
pub_type: 杂志文章,多中心研究
doi:10.1089/sur.2015.209
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Severe trauma leads to hematopoietic failure and bone marrow (BM) dysfunction that manifests clinically as a persistent anemia and leukopenia. The impact of severe trauma and its associated hyperadrenergic state on erythropoiesis has not been described. The aim of this study was to demonstrate the effects of...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2004.5.385
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Neutrophil dysfunction has been documented after injury in animals and human beings. This review evaluates the relative effects of the hormonal and endotoxin response to injury on immune resistance. METHOD:Review of the pertinent English-language literature. RESULTS:In volunteers given total parenteral nut...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2012.161
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Surgical care is delivered 24 h a day at most institutions. Alarmingly, some authors have found that certain operative start times are associated with greater morbidity and mortality rates. This effect has been noted in both the public and private sector. Although some of these differences may be related to ...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2015.150
更新日期:2016-10-01 00:00:00
abstract:: Background: Within the United States, surgical site infections (SSIs) have now become the most common hospital-acquired infection and impact 2%-5% of all surgical patients. It is estimated that approximately 60% of SSIs could be prevented through improved adherence to pre-...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.135
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Group A Streptococcus (GAS) is an uncommon cause of infection after clean surgery in non-pregnant adults. METHODS:Report of three cases and review of the literature. results: For the first time in France, severe GAS infections were observed in three patients who underwent thyroidectomy at three hospitals. T...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2007.069
更新日期:2008-10-01 00:00:00
abstract:: Background: A skin-sparing approach for the treatment of necrotizing soft-tissue infections (NSTIs) removes necrotic tissue planes while leaving viable overlying skin. Subsequent closure of the spared skin may decrease the need for graft-based reconstruction, which is asso...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.263
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Ventilator-associated pneumonia (VAP) is a common complication of critical illness among surgical and trauma patients. Inappropriate empiric treatment of VAP increases the mortality rate. The rates of Pseudomonas aeruginosa (PA) VAP susceptibility to doripenem (DOR) are higher than those to imipenem-cilastat...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.076
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:This report is a review of the published literature for studies of triclosan that address mechanism of action, efficacy on skin and in the oral cavity, and the potential for development of resistance. METHODS:Triclosan citations from the past three decades were searched using Medline and other search engine...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2002.3.s1-55
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Conceptually, appropriateness of antibiotic therapy includes choice of agent relative to susceptibility of pathogens as well as dosing, timing of onset, and duration of therapy, but is most commonly considered in terms of choice of antibiotic. It has been suggested that inappropriate antibiotic selection can...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2005.6.41
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Negative-pressure wound therapy (NPWT) has been suggetsed to have a positive impact on the healing of sternal or extremity wounds. However, few data deriving from breast surgery have been published. We evaluated the available literature regarding the effectiveness of NPWT systems in the healing of breast tis...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2013.165
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Prosthetic mesh is employed routinely in the treatment of ventral and parastomal hernias, but its use can lead to major complications, including infection, extrusion, and fistula. Bacterial biofilms have been posited to play a role in mesh-related infection, but although bacteria have been noted to form biof...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.026
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Intra-abdominal infection may lead to adhesion and abscess formation. An adhesion barrier can reduce these complications but also aggravate intra-peritoneal infection, causing the opposite effects. The fear of infection propagation has limited clinical adhesion barrier use in a contaminated or infected abdom...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.111
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The Gatti score is a weighted scoring system based on risk factors for deep sternal wound infection (DSWI) that was created in an Italian center to predict DSWI risk after bilateral internal thoracic artery (BITA) grafting. No external evaluation based on validation samples derived from other surgical center...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2016.150
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:We identified recently esophageal cancer related gene-4 (ECRG4) as a candidate cytokine that is expressed on the surface of quiescent polymorphonuclear leukocytes (PMNs) and shed in response to ex vivo treatment with lipopolysaccharide. To investigate the potential biologic relevance of changes in cell surfa...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2014.209
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The Surviving Sepsis Campaign (SSC) was launched in 2002 as a collaborative initiative of the European Society of Intensive Care Medicine (ESICM), the International Sepsis Forum (ISF), and the Society of Critical Care Medicine (SCCM). Its objective was, through the development and promulgation of evidence-ba...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2010.024
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Portal hypertension in the mucosa of the intestine and the presence of granulomas in the wall of this organ can alter digestive function in patients with schistosomiasis. Citrulline is a potential marker of intestinal function in some diseases that affect the morphometry of the mucosa because of its close as...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2009.066
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Extraintestinal Enterobius vermicularis infections are rare but may occasionally affect the female genital tract. Although mostly asymptomatic or causing minor clinical problems, they may lead to severe infectious complications. METHODS:Case report and review of the pertinent English language literature. R...
journal_title:Surgical infections
pub_type: 杂志文章,评审
doi:10.1089/sur.2008.090
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:The Donor Risk Index (DRI) is used to predict graft survival following liver transplantation, but has not been used to predict post-operative infections in graft recipients. We hypothesized that lower-quality grafts would result in more frequent infectious complications. METHODS:Using a prospectively collec...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2013.035
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Fungal sinusitis has been reported increasingly in immunocompetent patients. However, the most effective, appropriate mode of therapy has not been determined. MATERIALS AND METHODS:In this retrospective study, we examined the records of 110 immunocompetent patients with chronic sinusitis who had undergone s...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629603766956997
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Antimicrobial resistance is a growing problem in the intensive care setting. This study was designed to evaluate the trends in bacterial prevalence and changes in antibiotic resistance at a large university hospital over the past decade. Antimicrobial resistance data were compared among the surgical intensiv...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/109629602760105808
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Bacterial infections are a well-known complication of traumatic amputations. In cases involving contact with soil or water contaminated with manure, one also must be aware of infections with fungi, particularly Scedosporium spp. We report on an immunocompetent trauma patient with an infection caused by a rec...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2006.038
更新日期:2007-12-01 00:00:00
abstract:: Background: The use of mechanical bowel preparation and prophylaxis with oral antimicrobial agents can prevent surgical site infection (SSI) in colorectal surgical procedures, but routine adoption of these and other practices by surgeons has been limited. The aim of this s...
journal_title:Surgical infections
pub_type: 杂志文章
doi:10.1089/sur.2019.203
更新日期:2020-04-01 00:00:00