Prior Antibiotic Exposure Is Associated With Reoperation After Elective Non-colorectal Surgery-Reference-Cited by-同舟云学术

Prior Antibiotic Exposure Is Associated With Reoperation After Elective Non-colorectal Surgery

Published:2022-06-18 Issue:11 Volume:88 Page:2752-2759
ISSN:0003-1348
Container-title:The American Surgeon
language:en
Short-container-title:The American Surgeon

Author:

Guidry Christopher A.¹,Medvecz Andrew J.²,Adams Raeanna C.²,Dennis Bradley M.²,Eastham Shannon C.²,Guillamondegui Oscar D.²,Gunter Oliver L.²,Peetz Allan B.²³^ORCID,Thompson Callie M.²,Gondek Stephen P.²,Nunez Timothy C.²³,Sawyer Robert G.⁴,May Addison K.⁵,Patel Mayur B.²³

Affiliation:

1. Division of Trauma, Acute Care Surgery and Critical Care; Department of Surgery, The University of Kansas Medical Center, Kansas City, KS, USA

2. Division of Trauma, Emergency General Surgery, and Surgical Critical Care; Department of Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA

3. Surgical Services, Nashville Veterans Affairs Medical Center; Tennessee Valley Healthcare System, Nashville, TN, USA

4. Department of Surgery, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, MI, USA

5. Department of Surgery, Atrium Health, Charlotte, NC, USA

Abstract

Background Recent antibiotic exposure has previously been associated with poor outcomes following elective surgery. The purpose of this study is to evaluate the impact of prior recent antibiotic exposure in a multicenter cohort of Veterans Affairs patients undergoing elective non-colorectal surgery. Methods This is a retrospective cohort study of the Veterans Affairs Surgical Quality Improvement Program, including elective, non-cardiovascular, non-colorectal surgery from 2013 to 2017. Outpatient antibiotic exposure within 90 days prior to surgery was identified from the Veterans Affairs outpatient pharmacy database and matched with each case. Primary outcomes included serious complication, any complication, any infection, or surgical site infection. Secondary outcomes included 30-day mortality, length of stay, and Clostridioides difficile infection. Results Of 21,112 eligible patients, 2885 (13.7%) were exposed to antibiotics within 90 days prior to surgery with a duration of 7 (IQR: 5-10) days and prescribed 42 (IQR: 21-64) days prior to surgical intervention. Compared to non-exposed patients, exposed patients had higher unadjusted complication rates, increased length of stay, and rates of return to the operating. Exposure was independently associated with return to the operating room (OR: 1.39; 99% CI: 1.05-1.84). Conclusions Among Veterans, recent antibiotic exposure within 90 days of elective surgery was associated with a 39% increase in the odds of return to the operating room. Further work is needed to evaluate the effects of antibiotic exposure and dysbiosis on surgical outcomes.

Publisher

SAGE Publications

Subject

General Medicine

Link

http://journals.sagepub.com/doi/pdf/10.1177/00031348221109812

Reference25 articles.

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