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Surgery. 2014 Apr;155(4):675-81. doi: 10.1016/j.surg.2013.12.002. Epub 2013 Dec 14.

A prospective study on surgical-site infections in thyroid operation.

Author information

  • 1Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria; Department of Surgery, Kaiserin-Elisabeth-Spital, Vienna, Austria.
  • 2Second Department of Surgery, Krankenanstalt Rudolfstiftung, Vienna, Austria; Department of Urology, Medical University of Vienna, Vienna, Austria. Electronic address: tobias.klatte@gmx.de.
  • 3Department of Pathology and Microbiology with Hospital Hygiene Team, Kaiserin-Elisabeth-Spital, Vienna, Austria; Department of Pathology and Microbiology, Krankenanstalt Rudolfstiftung, Vienna, Austria.
  • 4Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen, Charité-Universitätsmedizin, Berlin, Germany.
  • 5Department of Pathology and Microbiology with Hospital Hygiene Team, Kaiserin-Elisabeth-Spital, Vienna, Austria.

Abstract

BACKGROUND:

To evaluate the incidence and the microbe spectrum of surgical-site infections (SSIs) in patients undergoing elective thyroid operation and to develop a risk factor-based predictive model.

METHODS:

This prospective study included 6,778 consecutive patients who underwent thyroid operation at a single institution between 2007 and 2012. SSI was defined according to the Centers for Disease Control and Prevention. Regression models were fitted to evaluate risk factors for SSI. A predictive nomogram was constructed from relevant variables in the multivariable analysis. Discrimination and calibration of the nomogram were assessed.

RESULTS:

The cumulative incidence of SSI after 30 days was 0.49%. The median time from operation to SSI was 7 days (interquartile range, 4-10.5 days). SSI was classified as superficial incisional in 30 cases (93.8%), deep incisional in 1 case (3.1%), and organ/space in 1 case (3.1%). Staphylococcus aureus was the most common isolate. In multivariable analysis, duration of operation (P = .004) and American Society of Anesthesiologists' score (P = .031) were identified as independent risk factors for SSI. These variables formed the basis of a nomogram, which was validated internally by bootstrapping and reached a predictive accuracy of 70.1%. The calibration curve showed a good agreement between predicted probability and actual observation.

CONCLUSION:

The cumulative incidence of SSI in thyroid operation is <0.5%. American Society of Anesthesiologists' score and the duration of operation are independent risk factors for SSI. Antibiotic prophylaxis may be considered for selected patients based on the individual risk profile.

Copyright © 2014 Mosby, Inc. All rights reserved.

PMID:
24502803
[PubMed - indexed for MEDLINE]
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