Analysis Of Risk Prediction To Surgical Site Infection In Colorectal Operation

Objectives:Thisstudywasdesignedtosurveythe risk factors for surgical-site infection after colorectal resection in domestic and foreign.To provide a scientific basis of surgical site infectionprevention andcontrol.Methods: we performed a meta-analysis of studies that the published studies were searched in the MEDLINE, EMBASE, Cochrane, CNKI, Wan Fang, VIP, CBM to identify all the relevant studies conducted from Jane 2000 to December 2015. The study that meet the inclusion and exclusion criteria and achieve Newcastle-Ottawa Scale(NOS) standard 5 points or more case-control study application Rev Man5.2 Meta-analysis software.Investigationof colorectal cancer risk factors for surgical site infection. One thousand and sixty-four patients who underwent colorectal operations from January 2013 to June 2015 were enrolled from the Shandong Provincial Hospital, Qilu Hospital, Wuhan Union Hospital, Xiangya Hospital, First Affiliated Hospital of Xinjiang Medical University, First Affiliated Hospital of Medical College of Shihezi University. Now through the medical records of a patient, comprising the collection of demographic characteristics, underlying diseases, surgery-related information, postoperative infection, use of antibiotics, pathogenic microbiology culture of 38 surgical site infection and related information. Depending on whether postoperative surgical site infection is divided into infection group and non-infection group, clinical data comparing two groups of patients, risk factors for surgical site infection using SPSS software univariate analysis and multivariate logistic regression analysis.Results:Totally 12 paper were included in this systematic evaluation,the 12 paper involved 11064 patients.Meta-analysis showed:the risk factors have the complication of diabetes(OR4.05;95%CI 2.45~6.75),Ⅲ/Ⅳcancer(OR1.61;95%CI 1.31~1.97), higher body mass index and long operation duration,low preoperative albumin(OR2.89;95%CI 2.04~4.09).Laparoscopic(OR0.31;95%CI 0.18~0.54) is the protective factor.Among 1064 patients, 138(12.97%) were diagnosed with SSI, 74 patients had superficial and 25 had deep tissue infection in incision site and 39 had organic infection after operation. Univariate and multivariate predictors of SSI showed the risk factors are as followed: COPD(OR=4.517)、Preoperative use of hormones( OR=3.319),Incision type( OR=5.064),operation duration( OR=1.849),ASA(OR=2.426),Emergency surgery(OR=5.82),7 days prior to surgery use of antimicrobial drugs(OR=2.246),Fat liquefaction(OR=13.808),Wound dehiscence(OR=84.829),Anastomotic leak(OR=27.111),After antibiotic treatment(OR=1.187).Conclusions:The risk factors for surgical site infection for the surgical-site infection after colorectal resection were higher body mass index, the complication of diabetes, COPD, Ⅲ/Ⅳcancer, low preoperative albumin, preoperative use of hormones, incision type, operation duration, ASA, emergency surgery, 7 days prior to surgery use of antimicrobial drugs, fat liquefaction, wound dehiscence, anastomotic leak, after antibiotic treatment. Laparoscopic is the protective factor.