Risk factors associated with the development of sepsis after reconstructive flap surgery^*

Abstract

Sepsis is a serious and potentially life-threatening condition. Risk factors that are associated with the development of sepsis may differ as it relates to reconstructive flap surgery. The purpose of this study is to identify the incidence and predictors for sepsis in patients undergoing reconstructive flap surgery. The ACS-NSQIP database was queried from 2005 to 2016 for factors related to sepsis in patients undergoing reconstructive flap surgery. CPT codes were used to identify patient cohorts. A sepsis group was compared to a control group that underwent the same procedures without the postoperative manifestations of sepsis. Statistical analyses were performed to ascertain risk factors associated with the development of sepsis. 24,257 patients who underwent flap reconstruction were included in this study. Of these, 511 developed sepsis postoperatively (2.1%). Multivariate analysis showed that male gender (p < .001), African-American race (p < .001), hypertension requiring medication (p < .001), smoking (p < .001), a higher Charlson comorbidity Index score (p < .001), evidence of preoperative wound infection (p < .001), chronic steroid use (p < .001), and prolonged operative time (p < .001) all significantly were associated with the development of sepsis. Sepsis resulted in a higher chance of 30-day mortality (p < .001) and increased the risk of developing septic shock (OR: 2.578, CI: 1.241–5.354) This study shows that postoperative sepsis is a serious complication of reconstructive flap surgery. Risk reduction and prevention of potentially life-threatening complications is always a priority. Awareness of the risk factors contributing to the development of sepsis is crucial for early intervention and treatment.

Keywords:

• Reconstructive flap surgery
• sepsis
• NSQIP

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Ethical approval

The patient information in this study is de-identified and available to all institutions complying with the American College of Surgeons National Surgical Quality Improvement program (ACS NSQIP) Data Use Agreement.

Disclaimer

The ACS NSQIP databases are the source of information used in this study. Data extrapolated, statistical analysis performed and conclusions reached have not been verified by the ACS NSQIP but rather are the result of the work done by authors of this study.

Disclosure statement

No potential conflict of interest was reported by the authors.