Patient Risk Factors for Mechanical Wound Complications and Postoperative Infections after Elective Open Intestinal Resection.

BACKGROUND: Few studies focused on the construction of preoperative patient surgical risk profile using only patients' personal, social history, and comorbidity profiles.

OBJECTIVE: To identify risk factors for mechanical wound complications and postoperative infections in patients' preoperative profiles.

DESIGN: Quantitative retrospective cohort study using 2009-2011 Health Care Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) databases.

PATIENTS: 56,853 patients who underwent elective open intestinal resection.

MEASUREMENTS: Predictors of mechanical wound complications and postoperative infections in patients' personal, social history, and comorbidity profiles.

RESULTS: Patients age 18-39 were more likely to suffer mechanical wound complications compared to patients age 65-79 (OR = 1.9, 95% CI [1.5, 2.4], p < .01) and to patients age 80 and over (OR = 2.9, 95% CI [2.2, 3.8], p < .01). Patients age 18-39 were also more likely to suffer postoperative infections compared to patients age 65-79 (OR = 1.4, 95% CI [1.1, 1.6], p < .01) and to patients age 80 and over (OR = 2.0, 95% CI [1.6, 2.6], p < .01). Other most significant predictors included male gender, fluid and electrolyte disorders, pulmonary circulation disorders, and weight loss, as well as patients with comorbidities. All statistically significant predictors with positive estimates for postoperative infections were also statistically significant predictors of mechanical wound complications.

CONCLUSIONS: Individual patient risk profile can be constructed using preoperative patient profiles for improving perioperative care coordination and patient care quality. Postoperative infections were associated with mechanical wound complications in patients undergoing elective open intestinal resection.