Incidence and predictors of deep incisional and organ/space surgical site infection following radical cystectomy

Ruben Blachman-Braun; Aaron A. Gurayah; Matthew M. Mason; Helen Y. Hougen; Mark L. Gonzalgo; Bruno Nahar; Sanoj Punnen; Dipen J. Parekh; Chad R. Ritch

doi:10.1016/j.urolonc.2023.06.016

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Incidence and predictors of deep incisional and organ/space surgical site infection following radical cystectomy

Journal article

Peer reviewed

Incidence and predictors of deep incisional and organ/space surgical site infection following radical cystectomy

Ruben Blachman-Braun, Aaron A. Gurayah, Matthew M. Mason, Helen Y. Hougen, Mark L. Gonzalgo, Bruno Nahar, Sanoj Punnen, Dipen J. Parekh and Chad R. Ritch

Urologic oncology, Vol.41(11), pp.455.e17-455.e24

11/01/2023

DOI: 10.1016/j.urolonc.2023.06.016

PMID: 37524577

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Abstract

•After radical cystectomy incidence of deep incisional or organ/space SSI is 8.1%.•Postoperative deep SSI is more frequent in obese, diabetic, and functionally dependent patients.•Continent urinary diversion approach is associated with an increased risk of deep SSI.•Deep SSI occurred most frequently in the second postoperative week (42% of cases). To investigate clinical risk factors associated with postoperative deep incisional or organ/space surgical site infections (SSI) following radical cystectomy (RC) in a well characterized and large contemporary cohort. We used the American College of Surgeons National Surgical Quality Improvement Program database to identify adult patients who underwent RC for bladder cancer between 2015 and 2020 (n = 13,081). We conducted multivariable-adjusted logistic regression and Cox adjusted proportional hazards regression analysis to identify clinical predictors of deep incisional or organ/space SSI in the 30-day postoperative-period following RC. Deep incisional or organ/space SSI risk increased with continent urinary diversion (HR = 1.61, 95% CI: 1.38–1.88; P < 0.001), obesity (HR = 1.60, 95% CI: 1.35-1.90; P < 0.001), diabetes mellitus (HR = 1.30, 95% CI: 1.13-1.51; P < 0.001), and being functionally dependent before surgery (HR = 2.09, 95% CI: 1.44–3.03; P < 0.001). Postoperative deep incisional or organ/space SSIs following RC occur more frequently in patients who were obese, diabetic, functionally dependent before surgery, and those who underwent continent urinary diversion. These findings may assist urologists in preoperative counseling, medical optimization, and choice of urinary diversion approach, as well as improved patient monitoring and identification of candidates for intervention postoperatively.

Cystectomy

Diabetes mellitus

Obesity

Surgical wound infection

Urinary diversion

Details

Title: Subtitle: Incidence and predictors of deep incisional and organ/space surgical site infection following radical cystectomy
Creators: Ruben Blachman-Braun - University of Miami
Aaron A. Gurayah - University of Miami
Matthew M. Mason - University of Miami
Helen Y. Hougen - University of Miami
Mark L. Gonzalgo - University of Miami
Bruno Nahar - University of Miami
Sanoj Punnen - Sylvester Comprehensive Cancer Center
Dipen J. Parekh - University of Miami
Chad R. Ritch - University of Miami
Resource Type: Journal article
Publication Details: Urologic oncology, Vol.41(11), pp.455.e17-455.e24
Publisher: Elsevier Inc
DOI: 10.1016/j.urolonc.2023.06.016
PMID: 37524577
ISSN: 1078-1439
eISSN: 1873-2496
Language: English
Date published: 11/01/2023
Academic Unit: Urology
Record Identifier: 9984701546302771

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