Abstract：
Introduction: Surgical site infection (SSI) is a substantial cause of peri-operative morbidity among patients undergoing radical cystectomy (RC). The purpose of this study was to identify the risk factors of SSI after RC and to classify and characterize treatment of SSIs. Methods: We retrospectively analyzed peri-operative characteristics and SSI, for patients undergoing RC from 2007 to 2022. Patients were stratified by SSI versus no SSI and differences were assessed. Uni-variable/multi-variable logistic regression analyses were performed to identify factors associated with SSI. SSIs were categorized by the Centers for Disease Control and Prevention (CDC) type: Superficial incisional, deep incisional, and organ/space confined. Results: Three hundred and ninety-eight patients had RC, 279 open, and 119 robotic; 78 (19.6%) developed SSI. Cohorts were similar demographically. Length of stay (LOS) was longer in the SSI cohort (8.8 d versus 12.4 d, p < 0.001), and body mass index (BMI) was greater in patients with SSI (24.34 vs. 25.39, p = 0.0003). On uni-variable analysis, age, gender, Charlson Comorbidity Index, diabetes mellitus, diversion, odds ratio (OR) time, blood loss, and open versus robotic technique were not substantial SSI predictors. BMI was an independent risk factor for SSI on both uni-variable (OR: 1.07, 95% confidence interval [CI]: 1.018-1.115, p = 0.0061) and multi-variable analysis (OR: 1.06, 95% CI: 1.009-1.109, p = 0.02) for 10 (12.8%) and 24 (30.8%) superficial and deep-incisional SSIs, respectively. Superficial wound SSI was treated conservatively with 60% receiving antibiotic agents and no procedural intervention. Deep SSIs received antibiotic agents and 50% required surgical intervention. There were 44 (56.4%) organ/space SSIs, and the most common treatment was antibiotic agents (100%) and IR drain placement (30, 68.2%). Conclusion: In patients undergoing RC, BMI was an independent risk factor for SSI. Type of the surgical procedure, robotic versus open, was not predictive of SSI. LOS was longer for patients with SSI. SSI was managed differently depending on CDC classification.
摘要：
简介：在接受根治性膀胱切除术（RC）的患者中，手术部位感染（SSI）是围手术期发病率的重要原因。这项研究的目的是确定RC后SSI的危险因素，并对SSIs的治疗进行分类和表征。方法：我们回顾性分析围手术期特征和SSI，2007年至2022年接受RC的患者。根据SSI和无SSI对患者进行分层，并评估差异。进行单变量/多变量逻辑回归分析以确定与SSI相关的因素。SSIs由疾病控制和预防中心（CDC）类型分类：浅表切口，深切口,和器官/空间受限。结果：三百九十八例患者有RC，279打开,119个机器人；78个（19.6%）开发了SSI。队列在人口统计学上相似。SSI队列中的住院时间（LOS）更长（8.8d对12.4d，p<0.001)，SSI患者的体重指数（BMI）更高（24.34vs.25.39,p=0.0003)。在单变量分析中，年龄,性别,Charlson合并症指数，糖尿病,分流,优势比(OR)时间，失血,开放式技术与机器人技术并不是重要的SSI预测因素。BMI是单变量（OR：1.07，95％置信区间[CI]：1.018-1.115，p=0.0061）和多变量分析（OR：1.06，95％CI：1.009-1.109，p=0.02）的独立危险因素10（12.8％）和24（30.8％）的浅表和深切口SSI，分别。60%接受抗生素治疗且无手术干预,保守治疗浅表伤口SSI。深层SSIs接受抗生素治疗，50%需要手术干预。有44个(56.4%)器官/空间SSIs，最常见的治疗是抗生素药物（100％）和IR引流（30，68.2％）。结论：在接受RC的患者中，BMI是SSI的独立危险因素。外科手术的类型,机器人与开放式，不能预测SSI。SSI患者的LOS更长。根据CDC分类，SSI的管理方式不同。
