Blackwood Brian P, Gause Colin D, Harris Jamie C, Theodorou Christina M, Helenowski Irene, Lautz Timothy B, Grabowski Julia, Hunter Catherine J
1 Department of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago , Chicago, Illinois.
3 Department of General Surgery, Rush University Medical Center , Chicago, Illinois.
Surg Infect (Larchmt). 2017 May-Jun;18(4):491-497. doi: 10.1089/sur.2016.179. Epub 2016 Dec 23.
Obesity is a known risk factor in adult surgical site infections (SSIs), but its significance in pediatrics is unclear. We hypothesized that overweight and obese children have increased risk for SSI.
A National Surgical Quality Improvement Program-Pediatric (NSQIP-P) file and single-center reviews identified surgical patients (2-18 years) who developed SSIs. Patients were classified as underweight, normal, overweight, or obese based on body mass index (BMI). Comorbidities associated with SSI were analyzed. Sub-specialties and operations were recorded.
National Surgical Quality Improvement Program-Pediatric review identified 66,671 patients and 1,380 SSIs. Seven hundred sixty-seven (767) were male and 613 female. Multivariable analysis revealed overweight and obese BMI to be risk factors for SSIs (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.06-1.43; OR 1.43, 95% CI 1.25-1.63). Most commonly, overweight and obese cohorts had superficial incisional SSIs. Pediatric general surgery (3.6%) and cardiothoracic surgery (2.5%) had the highest rates of SSIs. Single-center review identified 115 SSIs. Of these, 29.6% were overweight or obese with few other identifiable SSI risk factors. Sub-specialties with the most SSIs were pediatric surgery and pediatric orthopedics. Appendectomy was the most common procedure associated with SSIs.
Herein we show elevated BMI to be a significant risk factor for SSIs. This information should be used in assessing and counseling pre-operative pediatric patients and families.
肥胖是成人手术部位感染（SSI）的已知风险因素，但其在儿科中的意义尚不清楚。我们假设超重和肥胖儿童发生SSI的风险增加。
通过国家外科质量改进计划 - 儿科（NSQIP - P）文件和单中心回顾，确定发生SSI的手术患者（2至18岁）。根据体重指数（BMI）将患者分为体重过轻、正常、超重或肥胖。分析与SSI相关的合并症。记录亚专业和手术情况。
国家外科质量改进计划 - 儿科回顾确定了66671例患者和1380例SSI。其中767例为男性，613例为女性。多变量分析显示超重和肥胖的BMI是SSI的风险因素（比值比[OR] 1.23，95%置信区间[CI] 1.06 - 1.43；OR 1.43，95% CI 1.25 - 1.63）。最常见的是，超重和肥胖队列发生浅表切口SSI。小儿普通外科（3.6%）和心胸外科（2.5%）的SSI发生率最高。单中心回顾确定了115例SSI。其中，29.6%为超重或肥胖，几乎没有其他可识别的SSI风险因素。SSI最多的亚专业是小儿外科和小儿骨科。阑尾切除术是与SSI相关最常见的手术。
在此我们表明BMI升高是SSI的重要风险因素。该信息应用于评估和术前咨询儿科患者及其家属。
