Risk Factors for Surgical Site Infections after Laparoscopic Bariatric surgery: An Analysis of the MBSAQIP Database

Background: Surgical site infection (SSI) is a preventable postoperative complication. There is a paucity of literature on risk factors for SSI after bariatric surgery. The aim of this study was to evaluate risk factors for SSI after laparoscopic bariatric surgery using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Methods: Patients undergoing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) between 2015 and 2017 were identified from the MBSAQIP database. Descriptive analysis was used to evaluate associations between SSI and perioperative complications. Multivariate logistic regression analysis was used to identify predictors of SSI. Results: A total of 266,791 LSG and 104,442 LRYGB cases were identified with 2494 (0.67%) total cases of SSI (1595 cases of superficial SSI; 211 cases of deep/incisional SSI; 715 cases of organ-space SSI). SSI was associated with an increased risk of complications (32.5% vs. 3.08%; p\u3c0.01) and mortality (0.52% vs. 0.07%; p\u3c0.01). LRYGB was associated with higher risk of SSI compared to LSG (AOR 2.52; 95% CI 2.31-2.76; p\u3c0.01). The most predictive risk factors for SSI were body mass index ≥ 60 kg/m2 (AOR 1.71; 95% CI 1.33-2.21; p\u3c0.01) and steroid use (AOR 1.61; 95% CI 1.27-2.03; p\u3c0.01). Additional risk factors for SSI are listed in Table 1. Conclusions: Despite low incidence, SSI after laparoscopic bariatric surgery is associated with perioperative morbidity and mortality. Modifiable risk factors such as diabetes mellitus, smoking, and steroid use may provide an opportunity to decrease SSI risk. [Figure presented