XXXX Complications and Prophylaxis Patterns in Colorectal Surgery.

@entity1 @entity1211 @entity1031 @entity5
IMPORTANCE: @entity1211 ( @entity1211 ) is an important complication of colorectal surgery, but its incidence is unclear in the era of @entity1211 prophylaxis. OBJECTIVE: To describe the incidence of and risk factors associated with @entity1031 complications and contemporary @entity1211 prophylaxis patterns following colorectal surgery. DESIGN, SETTING, AND @entity1 : Prospective data from the Washington State Surgical Care and Outcomes Assessment Program (SCOAP) linked to a statewide hospital discharge database. At 52 Washington State SCOAP hospitals, @entity1 included consecutive @entity1 undergoing colorectal surgery between January 1, 2006, and December 31, 2011. MAIN OUTCOMES AND MEASURES: @entity1211 complications in-hospital and up to 90 days after surgery. RESULTS: Among 16   120 @entity1 (mean age, 61.4 years; 54.5% female), the use of perioperative and in-hospital @entity1211 chemoprophylaxis increased significantly from 31.6% to 86.4% and from 59.6% to 91.4%, respectively, by 2011 (P   <   .001 for trend for both). Overall, 10.6% (1399 of 13   230) were discharged on a chemoprophylaxis regimen. The incidence of @entity1211 was 2.2% (360 of 16   120). @entity1 undergoing abdominal operations had higher rates of 90-day @entity1211 compared with @entity1 having pelvic operations (2.5% [246 of 9702] vs 1.8% [114 of 6413], P   =   .001). Those having an operation for @entity5 had a similar incidence of 90-day @entity1211 compared with those having an operation for nonmalignant processes (2.1% [128 of 6213] vs 2.3% [232 of 9902], P   =   .24). On adjusted analysis, older age, nonelective surgery, history of @entity1211 , and operations for inflammatory disease were associated with increased risk of 90-day @entity1211 (P   <   .05 for all). There was no significant decrease in @entity1211 over time. CONCLUSIONS AND RELEVANCE: @entity1211 rates are low and largely unchanged despite increases in perioperative and postoperative prophylaxis. These data should be considered in developing future guidelines.
