Early postop infection ups one-year infection, mortality risk

(HealthDay)—Patients with 30-day postoperative infection have an increased risk for long-term infection and mortality, according to a study published online Nov. 6 in JAMA Surgery.

William J. O'Brien, from the Center for Healthcare Organization and Implementation Research in Boston, and colleagues conducted a retrospective observational cohort study to examine whether exposure to 30-day postoperative infection is associated with the incidence of infection and mortality during postoperative days 31 to 365. Data were included for 659,486 veterans undergoing major surgery.

The researchers found that 3.6 percent of the patients had a 30-day infection, 6.6 had a long-term infection, and 3.8 percent died during follow-up. Surgical site infection, urinary tract infection, pneumonia, and bloodstream infection were the most frequent 30-day infections (40.2, 27.5, 14.8, and 8.0 percent, respectively). Urinary tract infection, skin and soft tissue infection, bloodstream infection, and pneumonia were included as types of long-term infection (48.7, 32.6, 8.8, and 5.8 percent, respectively). Compared with those without 30-day infection, patients in the exposure group had a higher observed incidence of long-term infection (21.8 versus 6.1 percent) and mortality (12.9 versus 3.4 percent). The estimated hazard ratios for long-term infection and mortality were 3.17 and 1.89, respectively.

"Infection after surgery is associated with long-term harm, which should be accounted for in the costs and benefits of infection prevention programs," the authors write.

Two authors disclosed financial ties to the biopharmaceutical and medical technology industries.

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