Presentation Number:
Author(s): Tyler Leiva, University of Oklahoma; Katherine Snyder, University of Oklahoma; Alena Golubkova, University of Oklahoma; Camille Schlegel, University of Oklahoma; Catherine Hunter, University of Oklahoma
Eligible for the Resident Award
Presentation Number:
Author(s): Vishal Patel, ; Daniel Matienzo, HCA Westside; Shaikh Hai, HCA Westside
Presentation Number:
Author(s): Callie Winters, ; Johnathan Kent, University of Chicago; Ashley Sidebottom, University of Chicago; Remzi Bag, University of Chicago; Renea Jablonski, University of Chicago; Kevin Tsui, University of Chicago; Olga Zaborina, University of Chicago; John Alverdy, University of Chicago; Robert Guzy, University of Wisconsin; Maria Lucia Madariaga, University of Chicago
Presentation Number:
Author(s): Nicole Lyons, University of Miami Miller School of Medicine; Brianna Cohen, University of Miami Miller School of Medicine; Christopher O’Neil, University of Miami Miller School of Medicine; Walter Ramsey, University of Miami Miller School of Medicine; Kenneth G Proctor, University of Miami Miller School of Medicine; Nicholas Namias, University of Miami Miller School of Medicine; Jonathan Meizoso, University of Miami Miller School of Medicine
Eligible for the Resident Award
Presentation Number:
Author(s): Hanna Labiner, The Ohio State University Wexner Medical Center; Kelli Sas, The Ohio State University Wexner Medical Center; Joseph Baur, University of Pennsylvania; Carrie Sims, The Ohio State University Wexner Medical Center
Eligible for the Resident Award
Presentation Number:
Author(s): Alejandro De Filippis, ; Leonardo Diaz, Washington University in St. Louis; Ricardo Fonseca, Washington University in St. Louis; Melissa Canas, Washington University in St. Louis; Hussain Afzal, Washington University in St. Louis; Jennifer Leonard, Washington University in St. Louis; Mark Hoofnagle, Washington University in St. Louis; Kelly Bochicchio, Washington University in St. Louis; Grant Bochicchio, Washington University in St. Louis
Presentation Number:
Author(s): Sara Myers, Boston University School of Medicine; Crisanto Torres, Boston University School of Medicine; Lisa Allee, Boston Medical Center; Tracey Dechert, Boston University School of Medicine; Tejal Brahmbhatt, Boston University School of Medicine; Sabrina Sanchez, Boston University School of Medicine
Eligible for the Resident Award and New Member Award
Presentation Number:
Author(s): Rhett MacNeille, Loma Linda University; Johnson Lay, Loma Linda University; Jacob Razzouk, ; Shelly Bogue, Loma Linda University; Gideon Harianja, Loma Linda University; Evelyn Ouro-Rodrigues, Loma Linda University; Caleb Ting, University of California Riverside; Omar Ramos, Twin Cities Spine Center; Jennifer Veltman, Loma Linda University; Olumide Danisa, Loma Linda University
Eligible for the Resident Award
Author(s):
Abagail Raiter; Krista Wilhelmson; Melissa Harry; Kristin Colling
Background:
In the era of acute care surgery (ACS) urgent cholecystectomies (UC) performed by ACS specialists has led to higher rates of successful laparoscopic operations and improved outcomes, even with increased case complexity. However data on surgical infection risk following UC is lacking.
Hypothesis:
We hypothesize that patient and case complexity will be associated with higher rates of SSI.
Methods:
A prospective observational study was performed including all UC by the ACS team at a rural level 1 trauma center between April 2021 and March 2022. Patient demographics, comorbidities, hospital data, operative data and pathology were collected. The severity of cholecystitis was graded using the Parkland grading scale (PGS) for cholecystitis.
Results:
213 patients underwent UC. Patients ages ranged between 18-95, and approximately half were female (table below). Most patients had pre-existing comorbidities. Laparoscopic cholecystectomy was successful in 93% of cases, 4% converted to open, 2% underwent laparoscopic subtotal cholecystectomy and 0.5% underwent planned open procedure. SSI occurred in 17 patients (6 patients had superficial SSI, 10 organ space SSI and one patient both superficial and organ space SSI). Many pre-operative patient factors were associated with increased risk of infection; however none were modifiable. Antibiotic dosing and duration varied; similar number of patients received perioperative, both peri- and postoperative, and pre-, peri- and postoperative antibiotics. However, antibiotics pre- or postoperatively did not decrease infections. The SSI rate was similar or lower for patients receiving only peri-operative antibiotics compared to longer duration. Intra-operative factors associated with increased risk of SSI were severe cholecystitis (higher PCG scores), longer case duration, bile spillage, and surgical drains. Patients with SSI had significantly longer hospital stays and readmissions.
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Conclusions:
SSIs occurred in 8% of UCs. Pre and intraoperative factors were associated with increased risk of SSI and those with SSI had worse postoperative outcomes. Most factors were not modifiable prior to surgery but avoidance of bile spillage may decrease SSI. Appropriate antibiotic timing is still unclear, however more antibiotics did not decrease SSIs.
Presentation Number:
Author(s): Abagail Raiter, University of Minnesota Medical School Duluth Campus; Krista Wilhelmson, University of Minnesota Medical School Duluth Campus; Melissa Harry, Essentia Institute of Rural Health; Kristin Colling, Essentia Health-Saint Mary’s Medical Center
Eligible for the Non-Doctorate Award