We read with great interest the Clinical Practice Guidelines written by the European Society for Vascular Surgery on the management of vascular graft and endograft infections (VGEI).
1
The authors developed guidelines to assist physicians involved in the diagnosis and treatment of patient with VGEI.Independent patient related risk factors for surgical site infections of the lower limbs are summarised in Table 12 in the paper. We noticed that some results reported in the Guidelines are different from those shown in the cited references (Table 1), and that some other risk factors were not reported.
Table 1Patient related independent risk factors for surgical site infections of the lower limbs: differences compared with Table 12 of the Guidelines
1
are highlighted| Risk factor | Adjusted risk estimation – OR (95% CI) | Reference |
|---|---|---|
| Female sex | 1.44 (1.28–1.63) | Greenblatt et al. 2 |
| Obesity | 2.08 (1.78–2.43) | Greenblatt et al. 2 |
| BMI ≥ 25 kg/m2 | 1.78 (1.23–2.57) 1.28 (1.10–1.49) | Davis et al. 3 Greenblatt et al. 2 |
| COPD | 4.29 (2.74–6.72) 2.10 (1.07–4.09) 1.23 (1.03–1.43) | Davis et al. 3 Leekha et al. 4 Greenblatt et al. 2 |
| Dialysis | 4.35 (3.45–5.47) 1.51 (1.08–2.11) | Davis et al. 3 Greenblatt et al. 2 |
| CLI | 4.35 (3.45–5.47) 2.91 (1.61–5.27) | Davis et al. 3 Leekha et al. 4 |
| Re-intervention | 2.91 (1.61–5.27) 11 (1.9–63) | Leekha et al. 4 Brothers et al. 5 |
| Blood glucose > 11 mmol/L Peak glucose >180 mg/dL or > 10 mmol/L | 2.68 (1.38–5.22) 1.99 (1.53–2.57) | Leekha et al. 4 Davis et al. 3 |
| Hyponatraemia <134 g/dL | 11 (1.9–63) 1.20 (1.02–1.42) | Brothers et al. 5 Greenblatt et al. 2 |
| Post-operative immobilisation | None 1.20 (1.02–1.42) | None Greenblatt et al. 2 |
| Major amputation | 12 (4.1–34) | Brothers et al. 5 |
| Prior revascularisation | 2.68 (1.38–5.22) 1.57 (1.04–2.38) | Leekha et al. 4 Davis et al. 3 |
OR = odds ratio; CI = confidence interval; BMI = body mass index; COPD = chronic obstructive pulmonary disease; CLI = critical limb ischaemia.
We would like to ask authors how they achieved these results and what the criteria were for selecting risk factors.
References
- Editor's choice - European society for vascular surgery (ESVS) 2020 clinical Practice guidelines on the management of vascular graft and endograft infections.Eur J Vasc Endovasc Surg. 2020; 59: 339-384
- Predictors of surgical site infection after open lower extremity revascularization.J Vasc Surg. 2011; 54: 433-439
- Predictors of surgical site infection after open lower extremity revascularization.J Vasc Surg. 2017; 65: 1769-1778
- Preoperative risk prediction of surgical site infection requiring hospitalization or reoperation in patients undergoing vascular surgery.J Vasc Surg. 2016; 64: 177-184
- Predictors of prosthetic graft infection after infrainguinal bypass.J Am Coll Surg. 2009; 208: 557-561
Article info
Publication history
Published online: September 28, 2020
Accepted:
August 3,
2020
Received:
June 8,
2020
Footnotes
Note from the Editors
As a consequence of the inquiry by Tresson et al.,
1
the authors of the ESVS 2020 Clinical Practice Guidelines on the Management of Vascular Graft and Endograft Infections have published a Corrigendum.2
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