Predictors and costs of surgical site infections in patients with endometrial cancer

Jamie N. Bakkum-Gamez, Sean C. Dowdy, Bijan J. Borah, Lindsey R. Haas, Andrea Mariani, Janice R. Martin, Amy L. Weaver, Michaela E. McGree, William A. Cliby, Karl C. Podratz

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

Objective Technological advances in surgical management of endometrial cancer (EC) may allow for novel risk modification in surgical site infection (SSI). Methods Perioperative variables were abstracted from EC cases surgically staged between January 1, 1999, and December 31, 2008. Primary outcome was SSI, as defined by American College of Surgeons National Surgical Quality Improvement Program. Counseling and global models were built to assess perioperative predictors of superficial incisional SSI and organ/space SSI. Thirty-day cost of SSI was calculated. Results Among 1369 EC patients, 136 (9.9%) had SSI. In the counseling model, significant predictors of superficial incisional SSI were obesity, American Society of Anesthesiologists (ASA) score > 2, preoperative anemia (hematocrit < 36%), and laparotomy. In the global model, significant predictors of superficial incisional SSI were obesity, ASA score > 2, smoking, laparotomy, and intraoperative transfusion. Counseling model predictors of organ/space SSI were older age, smoking, preoperative glucose > 110 mg/dL, and prior methicillin-resistant Staphylococcus aureus (MRSA) infection. Global predictors of organ/space SSI were older age, smoking, vascular disease, prior MRSA infection, greater estimated blood loss, and lymphadenectomy or bowel resection. SSI resulted in a $5447 median increase in 30-day cost. Conclusions Our findings are useful to individualize preoperative risk counseling. Hyperglycemia and smoking are modifiable, and minimally invasive surgical approaches should be the preferred surgical route because they decrease SSI events. Judicious use of lymphadenectomy may decrease SSI. Thirty-day postoperative costs are considerably increased when SSI occurs.

Original languageEnglish (US)
Pages (from-to)100-106
Number of pages7
JournalGynecologic oncology
Volume130
Issue number1
DOIs
StatePublished - Jul 1 2013

Keywords

  • Cost-effective surgical care
  • Endometrial cancer
  • Minimally invasive surgery
  • Surgical site infection

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Fingerprint Dive into the research topics of 'Predictors and costs of surgical site infections in patients with endometrial cancer'. Together they form a unique fingerprint.

  • Cite this