Evidence map›Paper›PMID 28698181›Full record

ArticleCMAJ open2017

Risk factors for surgical site infection following cesarean delivery: a retrospective cohort study.

Felicia Ketcheson, Christy Woolcott, Victoria Allen, Joanne M Langley

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PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Felicia KetchesonAffiliations: Department of Community Health and Epidemiology (Ketcheson, Allen, Langley); Department of Pediatrics (Woolcott, Langley); Department of Obstetrics and Gynaecology (Woolcott, Allen), Dalhousie University; Canadian Centre for Vaccinology (Allen, Langley), IWK Health Centre, Halifax, NS.
Christy WoolcottAffiliations: Department of Community Health and Epidemiology (Ketcheson, Allen, Langley); Department of Pediatrics (Woolcott, Langley); Department of Obstetrics and Gynaecology (Woolcott, Allen), Dalhousie University; Canadian Centre for Vaccinology (Allen, Langley), IWK Health Centre, Halifax, NS.
Victoria AllenAffiliations: Department of Community Health and Epidemiology (Ketcheson, Allen, Langley); Department of Pediatrics (Woolcott, Langley); Department of Obstetrics and Gynaecology (Woolcott, Allen), Dalhousie University; Canadian Centre for Vaccinology (Allen, Langley), IWK Health Centre, Halifax, NS.
Joanne M LangleyAffiliations: Department of Community Health and Epidemiology (Ketcheson, Allen, Langley); Department of Pediatrics (Woolcott, Langley); Department of Obstetrics and Gynaecology (Woolcott, Allen), Dalhousie University; Canadian Centre for Vaccinology (Allen, Langley), IWK Health Centre, Halifax, NS.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe rate of cesarean delivery is increasing in North America. Surgical site infection following this operation can make it difficult to recover, care for a baby and return home. We aimed to determine the incidence of surgical site infection to 30 days following cesarean delivery, associated risk factors and whether risk factors differed for predischarge versus postdischarge infection.

methodsWe identified a retrospective cohort in Nova Scotia by linking the provincial perinatal database to hospital admissions and physician billings databases to follow women for 30 days after they had given birth by cesarean delivery between Jan. 1, 1997 and Dec. 31, 2012. Logistic regression with generalized estimating equations was used to determine risk factors for infection.

resultsA total of 25 123 women had 33 991 cesarean deliveries over the study period. Of the 25 123, 923 had surgical site infections, giving an incidence rate of 2.7% (95% CI 2.54%-2.89%); the incidence decreased over time. Risk factors for infection (adjusted odds ratios ≥ 1.5) were prepregnancy weight 87.0 kg or more, gaining 30.0 kg or more during pregnancy, chorioamnionitis, maternal blood transfusion, anticoagulation therapy, alcohol or drug abuse, second stage of labour before surgery, delivery in 1997-2000 and delivery in a hospital performing 130-1249 cesarean deliveries annually. Women who gave birth earlier in the study period, those who gave birth in a hospital with 130-949 cesarean deliveries per year and those with more than 1 fetus were at a significantly higher risk for surgical site infection before discharge; women who smoked were at significantly higher risk for surgical site infection after discharge.

interpretationMost risk factors are known before delivery, and some are potentially modifiable. Although the incidence of surgical site infection decreased over time, targeted clinical and infection prevention and control interventions could further reduce the burden of illness associated with this health-care-related infection.

Identifiers

PMID28698181
PMCPMC5621950

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.