Issue 16

Clinical Question

For IBD patients opting for elective colectomies, are they at increased risk for surgical site infections relative to patients with colon cancer and diverticulitis?

Editor’s Bottom Line

Patients operated on for their IBD have a significant increase in surgical site and deep infections compared to patients operated on for colon cancer and diverticulitis.

Reference

Bhakta A, Tafen M, Glotzer O, et al. Increased incidence of surgical site infection in IBD patients. Dis Colon Rectum. 2016 Apr;59(4):316–22. https://www.ncbi.nlm.nih.gov/pubmed/26953990

Synopsis

The American College of Surgeons’ National Surgical Quality Improvement Database was searched for elective colectomies for the treatment of IBD, colon cancer, and diverticulitis. Pre-, intra-, and post-operative variables were recorded as well as patient demographics and medications. Within 30 days of surgery, the primary outcomes were surgical site infections, deep organ or space infection referring to anatomical sites other than the surgical site, and resurgery.

Between 2008 and 2013, data was retrieved for 71,845 patients (11% IBD, 58% colon cancer, and 31% diverticulitis). The ratio for laparoscopic versus open surgery was nearly 1:1.

The table below outlines the increased rates of infections and return to the OR for infection in the IBD patients. BMI and smoking elevated odds ratios minimally in IBD.

Details

Study Design: Retrospective national database study
Funding: None
Allocation: n/a
Setting: US
Level of Evidence: 1b (Oxford Levels of Evidence)

The summary and conclusion in this issue of E-mentoring in IBD pertains to the manuscript(s) being reviewed, and should be considered in the context of what is already known surrounding the topic and incorporated into practice as deemed appropriate by the individual learner.