TY - JOUR
T1 - Risk of Infection after Penetrating Abdominal Trauma
AU - Nichols, Ronald Lee
AU - Smith, Jeffrey W.
AU - Klein, Daniel B.
AU - Trunkey, Donald D.
AU - Cooper, Ronald H.
AU - Adinolfi, Michael F.
AU - Mills, John
PY - 1984/10/25
Y1 - 1984/10/25
N2 - To identify the risk factors for the development of postoperative septic complications in patients with intestinal perforation after abdominal trauma, and to compare the efficacies of single-drug and dual-drug prophylactic antibiotic therapy, we studied 145 patients who presented with abdominal trauma and intestinal perforation at two hospitals between July 1979 and June 1982. Logistic-regression analysis showed that a higher risk of infection (P<0.05) was associated with increased age, injury to the left colon necessitating colostomy, a larger number of units of blood or blood products administered at surgery, and a larger number of injured organs. The presence of shock on arrival, which was found to increase the risk of infection when this factor was analyzed individually, did not add predictive power. Patients with postoperative sepsis were hospitalized significantly longer than were patients without infection (13.8 vs. 7.7 days, P<0.0001). Both treatment regimens — cefoxitin given alone and clindamycin and gentamicin given together—resulted in similar infection rates, drug toxicity, duration of hospitalization, and costs.
AB - To identify the risk factors for the development of postoperative septic complications in patients with intestinal perforation after abdominal trauma, and to compare the efficacies of single-drug and dual-drug prophylactic antibiotic therapy, we studied 145 patients who presented with abdominal trauma and intestinal perforation at two hospitals between July 1979 and June 1982. Logistic-regression analysis showed that a higher risk of infection (P<0.05) was associated with increased age, injury to the left colon necessitating colostomy, a larger number of units of blood or blood products administered at surgery, and a larger number of injured organs. The presence of shock on arrival, which was found to increase the risk of infection when this factor was analyzed individually, did not add predictive power. Patients with postoperative sepsis were hospitalized significantly longer than were patients without infection (13.8 vs. 7.7 days, P<0.0001). Both treatment regimens — cefoxitin given alone and clindamycin and gentamicin given together—resulted in similar infection rates, drug toxicity, duration of hospitalization, and costs.
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U2 - 10.1056/NEJM198410253111701
DO - 10.1056/NEJM198410253111701
M3 - Article
C2 - 6482920
AN - SCOPUS:0021135117
SN - 0028-4793
VL - 311
SP - 1065
EP - 1070
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 17
ER -