Issue: June 2019
April 30, 2019
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SSI rates differ by sex, procedures

Issue: June 2019
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Seven Johannes Sam Aghdassi, MD
Seven Johannes Sam Aghdassi

A patient’s sex plays a factor in determining the likelihood of a surgical site infection, or SSI, and the sex-based risk varies based on the type of surgical procedure, although the underlying reasons are unclear, researchers reported at the European Congress of Clinical Microbiology and Infectious Diseases.

“Different procedure types show diverse results, as male patients are at a higher risk for SSI following orthopedic and abdominal surgery and female patients are at a higher risk after open heart surgery,” Seven Johannes Sam Aghdassi, MD, a physician at Charité – University of Medicine in Berlin, told Infectious Disease News.

Aghdassi and colleagues analyzed data of surgical procedures from the German national nosocomial infection surveillance system, and included procedures conducted between 2008 and 2017. They excluded procedures conducted for one sex or those with fewer than 20,000 operations. They considered age, ASA score, wound contamination class, duration of surgery and seasons as factors.

Aghdassi and colleagues included 16 surgery types, with 1,286,437 individual procedures and 19,792 SSIs in their analysis. In addition to the results listed above, female patients had significantly higher SSI rates for general surgery, including hernia repair and thyroid struma surgery.

When the researchers used multivariable analysis for attributable sex-related risk, they reported that hip prosthesis, arthroscopic knee procedures, open colon surgery, coronary bypass surgery, revascularization of arteria occlusion, lumbar disk surgery, thyroid surgery and hernia repair were procedures in which risk factors differed by sex.

“A possible reason for gender differences in SSI rates for specific procedures may be due to differences in comorbidities, microbiome composition and body constitution,” Aghdassi said in a news release.

The researchers reported that a cause-and-effect relationship between sex and SSIs could not be established, but the association should be further investigated.

“The underlying reasons for these findings are not yet fully understood and will require further investigation,” Aghdassi told Infectious Disease News. “Recommendations for the prevention of SSIs may be derived from future deeper insights into the topic.” – by Bruce Thiel

Reference:

Aghdassi SJS, et al. Abstract O1170. Presented at ECCMID; April 13-16, 2019; Amsterdam.

Disclosures: The authors report no relevant financial disclosures.