Session Time: 6:00pm-7:00pm
Presentation Time: 6:30pm-6:35pm
*Purpose: The National Surgical Quality Improvement Program for Transplant (NSQIP-T) was designed to track surgical outcomes in adult liver and kidney transplants (KTX). The Pilot Beta Phase has captured data between March 1, 2017 and March 31, 2019, at 30 US centers. It is important to investigate how the pilot data informs us on recent outcomes. Increased BMI has historically been identified as a risk factor for SSI following KTX. We examined whether it is a risk factor for SSI in this cohort’s KTX recipients.
*Methods: Of the 3771 KTX recipients captured in NSQIP-T, 116 experienced at least 1 SSI. We divided the cohort into those who experienced an SSI (N=116) and those who did not (N=3655). We conducted univariate and multivariate log regression analyses to identify risk factors for SSI.
*Results: Significant cohort demographic characteristics are listed in Table 1. On multivariate regression, BMI was found to confer increased risk of SSI. Table 2 lists the significant variables on multivariate analysis. The influence of BMI on SSI incidence was investigated by a ROC curve: AUC=0.66 (95%CI=0.61-0.71). The cutoff value was selected from the coordinates of the curve at BMI=27.5 kg/m2.
Table 1. Significant cohort demographics
|Parameter||SSI present (N=116)||SSI absent (N=3655)||P-value|
|Non-private health insurance||69%||60%||0.008|
|BMI||31+5.81 kg/m2||27+36.7 kg/m2||<0.001|
|Albumin||3.7+5.14 g/dL||3.8+5.07 g/dL||0.01|
|Operative time||200+76.0 min||186+80.8 min||0.02|
|Length of stay||5+8.11days||4+3.80 days||<0.001|
Table 2. Significant risk factors for SSI on multivariate log regression
|Length of stay||1.07||1.04-1.11|
*Conclusions: Increasing BMI persists as a risk factor for SSI in this cohort, but most accurately predicts an SSI at a non-obese BMI=27.5 kg/m2. Therefore, obese and morbidly obese BMI cannot reliably be used in isolation as predictors of SSI in KTX recipients.
To cite this abstract in AMA style:Yaffe HC, Belli AK, Parekh JR, Sudan DL, Elias N, Conzen KD, Foley DP, Hirose R, Greenstein SM. Does the NSQIP-Transplant Experience Demonstrate That Obese Kidney Transplant Recipients are Still at Increased Risk for Surgical Site Infections? [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/does-the-nsqip-transplant-experience-demonstrate-that-obese-kidney-transplant-recipients-are-still-at-increased-risk-for-surgical-site-infections/. Accessed August 3, 2021.
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