"Greater Caution Needed for Infectious Complications After Major Abdominal Surgery for Severe Diseases"

A study has found that patients who have undergone abdominal surgery due to severe diseases such as cancer or end-stage kidney disease need to be more cautious about infectious complications after surgery.

The research team led by Professors Kim Eun-young and Lee Gyeo-ra from the Department of Critical Care Trauma Surgery at the Catholic University of Korea Seoul St. Mary's Hospital analyzed patients admitted to the intensive care unit (ICU) after surgery for abdominal infections and diagnosed with sepsis, confirming on the 4th that clinical deterioration can occur even if the secondary culture test results are negative.

To diagnose sepsis, culture tests are conducted by collecting blood or secretion samples from the wound site of the patient. Until now, the clinical significance of secondary culture studies has been relatively insufficient compared to primary studies.

The research team included patients admitted to the ICU after surgery for abdominal infections and diagnosed with postoperative sepsis. The primary culture test was performed immediately after surgery, and the secondary culture test was conducted within 48 hours to 7 days post-surgery. The subjects were divided into culture-positive sepsis and culture-negative sepsis groups based on culture positivity, and clinical outcomes were compared. Factors predisposing to secondary culture-negative sepsis after surgery were also determined. There was no difference in ICU and hospital mortality rates between the groups in clinical outcomes.

As a result, among 83 subjects who progressed to sepsis, 32 patients (38.6%) showed secondary culture negativity. To verify whether the probability of a negative result in the secondary sepsis culture test was higher, multivariate logistic regression analysis was performed, confirming that patients who did not undergo intestinal surgery were 6.934 times, those without diabetes were 4.027 times, and those who received long-term antibiotic treatment for more than 3 days before surgery were 1.187 times more likely to be diagnosed as culture-negative in the secondary sepsis culture test.

Professor Kim Eun-young stated, "Infectious sepsis after abdominal surgery can lead to death despite successful surgery, so rapid and appropriate treatment such as proper antibiotic therapy is essential," adding, "In cases where the patient underwent surgery other than intestinal surgery, has no diabetes, or received antibiotics for more than 3 days before surgery, even if the sepsis culture test results are negative, careful monitoring is necessary to check whether the inflammatory response in the body is still progressing."

Professor Lee Gyeo-ra explained, "Since there was no significant difference in mortality according to secondary culture positivity in postoperative sepsis patients, the possibility of clinical deterioration should be considered even if the culture test results are negative."

The results of this study were published in the May issue of the SCI international journal Asian Journal of Surgery.

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