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This model calculates the preoperative probability of developping a surgical site infection (SSI) after liver resection. SSI may either be an incisional infection or an intra-abdominal infection. Additional measures may be taken in patients with increased risk.
The model was created in a Dutch multicenter cohort study, and is based on logistic regression. The study included 982 liver resections, both benign and malignant indications.
The model was created in a Dutch multicenter cohort study, and is based on logistic regression. The study included 982 liver resections, both benign and malignant indications.
Research authors: G.W. de Klein, M.J. Bruins, M.S.L. Liem, H. Eker, J.M. Klaase, V.B. Nieuwenhuijs
Details
Formula
Study characteristics
Files & References
★★
Model author
Model ID
2006
Version
1.3
Revision date
2020-01-16
Specialty
MeSH terms
Model type
Logistic regression
(Calculation)
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Additional information
This cohort study used data from prospectively held databases from four high-volume HPB centers, including one academic center. All patients who underwent liver resection (primary and repeat) between 2013 and 2017 for both malignant and benign indications were included. Patients with trauma-related resections, donor hepatectomy, and patients who only underwent radiofrequency ablation (RFA) were excluded.Stepwise logistic regression was used to detect independent predictors for SSI. The predictors that were known preoperatively were used to create a nomogram to indicate the probability of the development of a SSI of individuals
Study Population
Total population size: 982Males: {{ model.numberOfMales }}
Females: {{ model.numberOfFemales }}
Continuous characteristics
| Name | Mean | SD | Unit |
|---|---|---|---|
| Age | 73 | 10 | year |
| BMI | 26.5 | 4.5 | kg/m² |
| Name | LL | Q1 | Median | Q3 | UL | Unit |
|---|---|---|---|---|---|---|
| Operative time | 120 | 228 | 449 | minutes | ||
| Blood loss | 200 | 400 | 775 | mL |
Categorical characteristics
| Name | Subset / Group | Nr. of patients |
|---|---|---|
| SSI | Yes | 80 |
| No | 902 | |
| Type resection | Major | 289 |
| Minor | 693 | |
| Simultaneous liver and colorectal resection | Yes | 154 |
| No | 828 | |
| Concomitant RFA | No | 869 |
| Yes | 113 | |
| Indication | Colorectal metastasis | 693 |
| Primary liver tumor | 80 | |
| Metastasis non-colorectal | 56 | |
| Benign | 122 | |
| Approach | Open | 836 |
| Laparoscopy | 146 | |
| Present liver disease | No | 956 |
| Hepatitis | 17 | |
| Cirrhosis | 9 | |
| Abdominal comorbidity | No | 891 |
| Yes | 91 | |
| Physical status classification | ASA I | 208 |
| ASA II | 613 | |
| ASA III | 156 | |
| ASA IV | 4 | |
| Diatabetes | No | 882 |
| Yes | 100 |
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Evidencio B.V. |
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Refer to Intended Use for instructions before use |
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Evidencio B.V., Irenesingel 19, 7481 GJ, Haaksbergen, the Netherlands |
Related files
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381.97 kB | Figure |
Supporting Publications
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A nomogram predicting surgical site infection before liver resection, a multicenter cohort study
DOI:
Prepublication
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Internal validation Paper |
The pre-operative risk of surgical site infection after liver resection is ...
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The pre-operative risk of surgical site infection after liver resection is
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Outcome stratification
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Precautionary measures in high risk patients might include an extended antimicrobial prophylaxis, for instance based on rectal cultures that may be obtained preoperatively to detect colonization of resistant microbes and adjust antibiotic prophylaxis. Furthermore, a more extensive antiseptic regime for instance with chlorhexidine body wash preoperatively, the use of antimicrobial coated sutures, and the use of wound protectors or negative pressure wound therapy. Finally, enhanced nutritional support, and physical prehabilitation to optimize the immuno-nutritional status, might reduce the risk of SSI. See also the WHO Global guidelines on the prevention of surgical site infection.
Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.
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