Clinical ScienceTiming of postoperative infections after colectomy: evidence from NSQIP

- Infections are the most common complications after colon surgery.
- Risk factors differ between the inpatient and postdischarge periods.
- Earlier discharge may shift recognition of infections to the outpatient setting.

BackgroundWe studied whether risk factors for infectious complications differed between inpatient (IP) and postdischarge (PD) periods in patients undergoing colon surgery.MethodsAmong partial colon resection patients in the National Surgical Quality Improvement Program (2005 to 2010), we identified risk factors for superficial and deep (D-SSI) surgical site infections and urinary tract infections in the IP and PD phases of care.ResultsObesity was associated with higher risk of both IP superficial surgical site infections and D-SSI (odds ratio [OR] 1.41, P < .0001 and OR 1.28, P < .0001) and increasing to OR 1.73 (P < .0001) and OR 1.83 (P < .0001), respectively, in the PD period. Smoking was associated with development of D-SSI, and this risk increased from IP to PD phases of care (OR 1.15, P = .02 to OR 1.54, P < .0001).ConclusionsRisk factors for infections differ between IP and PD phases of care in colon surgery patients. Earlier discharge from the hospital may shift recognition of an SSI to the outpatient setting.