Impact of obesity on the risk of wound infection following surgery: Results from a nationwide prospective multicentre cohort study in England

S. Thelwall*, P. Harrington, E. Sheridan, Theresa Lamagni

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

62 Citations (Scopus)

Abstract

We sought to assess the impact of body mass index on the risk of surgical site infection in a prospective cohort study of 206 National Health Service (NHS) hospitals in England between 2007 and 2011. Body mass index was available for 159 720 of 350 089 operations among patients undergoing abdominal hysterectomy, coronary artery bypass graft, hip replacement, knee replacement, or large-bowel surgery. Among these patients, the risk of surgical site infection ranged from 0.65% for knee replacement to 11.04% for large-bowel surgery. Overall, 127 512 (79.8%) patients were overweight or obese (body mass index of ≥25 kg/m2). Obesity was associated with a 1.1-fold to 4.4-fold increase in the adjusted odds of developing surgical site infection as compared with normal weight, depending on the type of surgery. The population-attributable fraction (PAF) for body mass index was greatest in overweight (body mass index of 25.0-29.9 kg/m2) patients undergoing coronary artery bypass graft, accounting for 15% of their overall risk of surgical site infection (PAF 0.15; 95% CI 0.09-0.22). Being overweight or obese substantially increased the likelihood of patients developing surgical site infection. Given the increasingly high proportion of the surgical population who are overweight, this is likely to place a considerable additional burden on the NHS. Strategies for mitigating this excess risk need to be found.

Original languageEnglish
Pages (from-to)1008.e1-1008.e8
JournalClinical Microbiology and Infection
Volume21
Issue number11
DOIs
Publication statusPublished - Nov 2015

Bibliographical note

Publisher Copyright:
© 2015.

Keywords

  • Arthroplasty
  • Colorectal surgery
  • Coronary artery bypass
  • Epidemiology
  • Hip replacement
  • Hysterectomy
  • Knee replacement
  • Morbid obesity
  • Surgical wound infection

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