Impact of Advancing Age on the Status and Risk of Postoperative Infections After Liver Resection

• Published in: World journal of surgery Vol. 45; no. 11; pp. 3386 - 3394
• Main Authors: Kinoshita, Masahiko, Shinkawa, Hiroji, Kabata, Daijiro, Tanaka, Shogo, Takemura, Shigekazu, Amano, Ryosuke, Kimura, Kenjiro, Ohira, Go, Nishio, Kohei, Kubo, Shoji
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.11.2021; Springer Nature B.V
• Subjects: Abdominal Surgery; Age; Cardiac Surgery; General Surgery; Health risks; Infections; Laparoscopy; Liver; Medicine; Medicine & Public Health; Organs; Original Scientific Report; Postoperative period; Risk; Sepsis; Spline functions; Surgery; Surgical site infections; Thoracic Surgery; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-021-06236-8

Background Despite the recently increasing number of elderly patients undergoing liver resection, the impact of advancing age on postoperative infections (PIs) incidence and risk remains unclear. This study aimed to investigate the impact of advancing age on PIs incidence and status. Methods This retrospective study included 744 patients undergoing liver resection without biliary reconstruction or combined resection of other organs. Multivariable analysis with a restricted cubic spline was used to evaluate the impact of advancing age on PIs and to determine its association with PIs risk in patients undergoing open and laparoscopic liver resection (OLR and LLR, respectively). Results Multivariable analysis demonstrated that advancing age was significantly associated with increased PIs risk ( P  = 0.017). The spline curve showed that the odds ratio for PIs sharply increased starting approximately at 65 years of age. Unadjusted restricted cubic splines assessing the subcategories of PIs demonstrated that advancing age was associated with increased risks of organ/space surgical site infection and sepsis ( P  = 0,064 and 0.048, respectively). Multivariable analysis revealed that LLR was associated with the lower PIs risk compared with OLR ( P  = 0.025), whereas the lower PIs risk with LLR was not significantly obscured by advancing age ( P  = 0.29). Conclusions Advancing age was associated with increased risk of PIs, including organ/space surgical site infections and sepsis, after liver resection especially in patients aged ≥ 65 years.