Surgical site infection in hepatobiliary surgery patients and its relationship with serum vitamin D concentration

Cir Esp (Engl Ed). 2020 Oct;98(8):456-464. doi: 10.1016/j.ciresp.2020.03.004. Epub 2020 Jul 25.
[Article in English, Spanish]

Abstract

Introduction: While several studies have examined the correlation between vitamin D concentrations and post-surgical nosocomial infections, this relationship has yet to be characterized in hepatobiliary surgery patients. We investigated the relationship between serum vitamin D concentration and the incidence of surgical site infection (SSI) in patients in our hepatobiliary surgery unit.

Methods: Participants in this observational study were 321 successive patients who underwent the following types of interventions in the hepatobiliary surgery unit of our center over a 1-year period: cholecystectomy, pancreaticoduodenectomy, total pancreatectomy, segmentectomy, hepatectomy, hepaticojejunostomy and exploratory laparotomy. Serum vitamin D levels were measured upon admission and patients were followed up for 1 month. Mean group values were compared using a Student's T-test or Chi-squared test. Statistical analyses were performed using the Student's T-test, the Chi-squared test, or logistic regression models.

Results: Serum concentrations >33.5 nmol/l reduced the risk of SSI by 50%. Out of the 321 patients analyzed, 25.8% developed SSI, mainly due to organ-cavity infections (incidence, 24.3%). Serum concentrations of over 33.5 nmol/l reduced the risk of SSI by 50%.

Conclusions: High serum levels of vitamin D are a protective factor against SSI (OR, 0.99). Our results suggest a direct relationship between serum vitamin D concentrations and SSI, underscoring the need for prospective studies to assess the potential benefits of vitamin D in SSI prevention.

Keywords: Cirugía hepatobiliopancreática; Hepatobiliary surgery; Infección del sitio quirúrgico; Infección nosocomial; Nosocomial infection; Pancreatic surgery; Surgical site infection; Vitamin D; Vitamina D.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Cross Infection / blood
  • Cross Infection / epidemiology
  • Digestive System Diseases / surgery*
  • Digestive System Surgical Procedures / adverse effects*
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / microbiology
  • Prospective Studies
  • Protective Factors
  • Surgical Wound Infection / blood*
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / epidemiology
  • Vitamin D / blood*

Substances

  • Vitamin D