The impact of recent hospitalization on surgical site infection after a pancreatectomy

BackgroundSurgical site infections (SSI) are a major cause of increased morbidity and cost after a pancreatectomy. Patients undergoing a pancreatectomy frequently have had recent inpatient hospital admissions prior to their surgical admission (recent pre‐surgical admission, RPSA), which could increase the risk of SSI.MethodsThe 2009–2011 Healthcare Cost Utilization Project California State Inpatient Database was used. Chi‐square tests, Student's t‐tests and multivariable logistic regression were used.ResultsThree thousand three hundred and seventy‐six patients underwent a pancreatectomy, and 444 (13.2%) had RPSA. One hundred and eighty (40.5%) RPSAs were to different hospitals other than where patients' pancreatectomy took place. In univariate analysis, patients with RPSA had a significantly higher rate of post‐operative SSIs, and this was associated with a longer length of post‐operative stay, higher post‐operative hospital costs and increased postoperative 30‐day readmission rates (Table 1). In Multivariate analysis, RPSA was an independent predictor of post‐operative SSI [odds ratio (OR) = 1.68, P= 0.013], and the risk of SSI increased with increasing RPSA length of stay (OR = 1.07 per day, P = 0.001).ConclusionsRecent pre‐surgical admission is an important risk factor for SSI after a pancreatectomy. Many patients with RPSA are not admitted pre‐operatively to the same hospital where the pancreatectomy occurs; in such circumstances, SSI rates may not be a sole reflection of the care provided by operating hospitals.