PRS AAPS Oral Proofs 2016
Efstathios Karamanos, MD, Aamir Siddiqui, MD
From the Henry Ford Hospital, Detroit, Mich.
PURPOSE: The use of antibiotics for prophylaxis for elective surgeries is a common practice among surgeons in an effort to prevent surgical site infections (SSIs). In many cases, the use of antibiotics is not only unnecessary but also dangerous resulting in serious complications. This study aims to assess the impact of antibiotic prophylaxis on SSIs.
METHODS: The Michigan Surgical Quality Collaborative Database was queried for patients undergoing elective abdominal wall reconstruction from 2013 to 2015. A logistic regression was performed to identify the independent predictors for SSIs development, and a composite score was created. The study population was divided into groups based on their score, and the impact of preoperative antibiotics was examined.
RESULTS: A total of 4983 patients were identified. The incidence of SSIs was 3.35% (n = 167). Based on the scoring system, 2 groups were identified regarding the development of SSI [low risk (<12), 0%–4% vs high risk (≥12), 7%–24%, P < 0.05]. Preoperative antibiotics had no impact on the development of SSIs for the low-risk group [AOR (95% confidence interval), 2.04 (0.64–6.50)]. Interestingly, preoperative antibiotics reduced the probability of SSIs development by 50% [AOR (95% confidence interval), 0.51 (0.24–0.78)].
CONCLUSIONS: The proposed scoring system accurately predicts the development of SSIs in patients undergoing elective abdominal wall reconstruction. The use of the scoring system could guide the surgeon’s decision regarding administration of preoperative antibiotics.