Predictors of Infectious Complications Following Emergency Colectomy: A Nationwide Analysis

BACKGROUND: Infectious complications following emergency colectomy are a significant cause of morbidity and mortality. We aimed to identify predictors of infection after emergency colectomy. PATIENTS AND METHODS: We analyzed the 2013-2017 American College of Surgeons National Surgical Quality Improvement Program database to identify patients ≥ 18 years undergoing emergency colectomy. The primary outcome was post-operative infectious complication rate, defined as the presence of sepsis, septic shock, surgical site infection, pneumonia, or urinary tract infection. Multivariable logistic regression was used to investigate the effect of pre-operative/operative factors on infection risk. RESULTS: Of 40,913 included patients, 17,481 (42.7%) developed infectious complications. On multivariable analyses, pre-operative factors associated with increased odds of infectious complications were body mass index ≥30, chronic obstructive pulmonary disease, bleeding disorder, ascites, smoking, dependent functional status, American Society of Anesthesiologists ≥3, blood urea nitrogen ≥ 20 mg/dL, and albumin ≤ 3 g/dL. Additionally, dirty wound class and open, delayed, or prolonged surgical procedure were associated with increased infection risk. CONCLUSIONS: Identifying predictors of infection following emergency colectomy may inform perioperative decision-making and guide strategies to reduce infection-related morbidity.