Prior inpatient admission increases the risk of post‐operative infection in hepatobiliary and pancreatic surgery

AbstractBackgroundHepatobiliary and pancreatic (HPB) operations have a high incidence of post‐operative nosocomial infections. The aim of the present study was to determine whether hospitalization up to 1 year before HPB surgery is associated with an increased risk of post‐operative infection, surgical‐site infection (SSI) and infection resistant to surgical chemoprophylaxis.MethodsA retrospective cohort study of patients undergoing HPB surgeries between January 2008 and June 2013 was conducted. A multivariable logistic regression model was used for controlling for potential confounders to determine the association between pre‐operative admission and post‐operative infection.ResultsOf the 1384 patients who met eligibility criteria, 127 (9.18%) experienced a post‐operative infection. Pre‐operative hospitalization was independently associated with an increased risk of a post‐operative infection [adjusted odds ratio (aOR): 1.61, 95% confidence interval [CI]: 1.06–2.46] and SSI (aOR: 1.79, 95% CI: 1.07–2.97). Pre‐operative hospitalization was also associated with an increased risk of post‐operative infections resistant to standard pre‐operative antibiotics (OR: 2.64, 95% CI: 1.06–6.59) and an increased risk of resistant SSIs (OR: 3.99, 95% CI: 1.25–12.73).DiscussionPre‐operative hospitalization is associated with an increased incidence of post‐operative infections, often with organisms that are resistant to surgical chemoprophylaxis. Patients hospitalized up to 1 year before HPB surgery may benefit from extended spectrum chemoprophylaxis