Preoperative urinary tract infection increases postoperative morbidity
Courtney J Pokrzywa1, Christina M Papageorge1, Gregory D Kennedy1
1Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
The Journal of Surgical Research
|September 14, 2016
Summary
Preoperative urinary tract infection (UTI) increases the risk of postoperative complications in general surgery patients. Diagnosing and treating UTI before elective surgery may improve patient outcomes and reduce surgical site infections.
Area of Science:
- Surgical Outcomes Research
- Infectious Disease Epidemiology
- General Surgery
Background:
- Preoperative urinary tract infection (UTI) is a potential risk factor for postoperative complications via hematogenous spread.
- The association between preoperative UTI and adverse outcomes in general surgery has not been thoroughly investigated.
Purpose of the Study:
- To evaluate the association between preoperative urinary tract infection (UTI) and postoperative complications in patients undergoing elective general surgery.
Main Methods:
- Retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database (2011-2013).
- Identified patients with UTI present at the time of surgery (PATOS) and matched them 2:1 with controls without UTI.
- Utilized univariate and multivariate analyses to compare postoperative outcomes.
Main Results:
- A total of 434,802 patients were analyzed, with a preoperative UTI rate of 0.1%.
- Patients with preoperative UTI exhibited a significantly higher incidence of overall, infectious, and noninfectious complications.
- Multivariate analysis confirmed that preoperative UTI is an independent risk factor for increased postoperative complications (OR 1.551).
Conclusions:
- Preoperative UTI is associated with a higher rate of 30-day complications in elective general surgery.
- Prompt diagnosis and treatment of UTI before surgery are crucial for improving patient outcomes.
- Consideration should be given to postponing elective procedures until preoperative UTI is fully resolved.
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