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Matsuo K et al. - 1 Supplemental file for:
Significance of Perioperative Infection in Survival of Ovarian Cancer
Koji Matsuo, MD1,*; Christina P. Prather, MD2; Edward H. Ahn, MD3; Michele L. Eno, MD4;
Katherine E. Tierney, MD1; Annie A. Yessaian, MD1; Dwight D. Im, MD5; Neil B.
Rosenshein, MD5; Lynda D. Roman, MD1,6
1) Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University
of Southern California, Los Angeles County Medical Center, Los Angeles, CA, USA.
2) Department of Internal Medicine, University of North Carolina, Chapel Hill, NC, USA.
3) Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
4) Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles,
CA, USA.
5) The Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA.
6) Women’s Cancer Program, Norris Cancer Center, University of Southern California, Los
Angeles, CA, USA.
*) All correspondence to:
Koji Matsuo, MD
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
University of Southern California, Los Angeles Country Hospital
2020 Zonal Avenue, IRD520, Los Angeles, CA 90031
Tel: +1-323-226-3416, Fax: +1-323-226-2734, Email: [email protected]
Keywords: ovarian cancer; perioperative infection; surgical mortality; survival; prediction.
Part of data was presented at 42nd Annual Meeting of Society of Gynecologic Oncologists
(SGO), Orland, FL, USA, March 6-9, 2010.
Matsuo K et al. - 2 Table S1. Microorganisms isolated from perioperative infection in ovarian cancer
Types of microorganism
Enterococcus species§
Escherichia coli
Candida albicans
Klebsiella pneumoniae
Bacteroides fragilis
Coagulase negative staphylococcus
Staphylococcus aureus
Proteus mirabilis
Enterobacter cloacae
Pseudomonas aeruginosa
Vancomycin resistant enterococcus
Acinetobacter baumannii / haemophilus
Citrobacter amalonaticus
Clostridium difficile
Corynebacterium jeikeium
Enterobacter agglumerans
Klebsiella oxytoca
Alpha streptococcus
Citrobacter freundii
Diphtheroids
Morganella morganii
Morganella morganii
Stenotrophomonas maltophilia
Streptococcus agalactiae group B
No. (%)
18 (15.4%)
17 (14.6%)
14 (12.0%)
13 (11.1%)
10 (8.5%)
6 (5.1%)
6 (5.1%)
5 (4.3%)
4 (3.4%)
3 (2.6%)
3 (2.6%)
2 (1.7%)
2 (1.7%)
2 (1.7%)
2 (1.7%)
2 (1.7%)
2 (1.7%)
1 (0.9%)
1 (0.9%)
1 (0.9%)
1 (0.9%)
1 (0.9%)
1 (0.9%)
1 (0.9%)
117 specimens with positive result for pathogen out of 404 tested samples were catalogued.
§ excluded vancomycin resistant enterococcus.
Matsuo K et al. - 3 Table S2. Laboratory values and perioperative infection in ovarian cancer
Postop day 1
WBC
Hb
Plt
Na
K
Cl
HCO3
BUN
Cr
Glucose
Ca
Alb
Mg
Phos
Postop day 2
Postop day 3
Odds R (95%CI)
P-value
OR (95%CI)
P-value
OR (95%CI)
P-value
1.12 (1.04-1.21)
0.002
0.24
0.77
0.83
0.31
0.8
0.001
0.002
0.7
0.5
0.77
0.32
0.49
0.012
1.11 (1.03-1.19)
0.006
0.55
0.76
0.35
0.13
<0.0001
<0.0001
0.007
<0.0001
0.95
0.21
0.11
0.68
<0.0001
1.16 (1.07-1.27)
0.001
0.53
0.71
0.32
0.24
0.76
<0.0001 §
<0.0001 ‡
<0.0001
0.059
0.068
0.18
0.12
0.25
0.83 (0.75-0.92)
1.09 (1.03-1.15)
1.7 (1.2-2.42)
1.23 (1.12-1.35)
0.84 (0.77-0.92)
1.06 (1.02-1.1)
6.67 (2.67-16.7)
2.02 (1.38-2.96)
0.79 (0.71-0.87)
1.15 (1.09-1.22)
6.14 (2.24-16.8)
Logistic regression analysis for perioperative infection (OR is per unit change for all).
Multivariate analysis is significant for postop day 3 values for HCO3 (§ p=0.032) and BUN
(‡ p<0.0001). Abbreviations: Postop, postoperative; OR, odds ratio; 95%CI, 95%
confidence interval; WBC, white blood cells; Hb, hemoglobin; Plt, platelet; Na, sodium; K,
potassium; Cl, chloride; HCO3, bicarbonate; BUN, blood urea nitrogen; Cr, creatinin; Ca,
calcium; Alb, albumin; Mg, magnesium; and Phos, phosphorus.
Since the majority of perioperative infection occurred more than a week after the surgery,
we evaluated the laboratory tests in the immediate postoperative period in order to identify
a possible association with risk of subsequent perioperative infection. Among evaluated
parameters, increased total WBC count and BUN as well as decreased HCO3 were
associated with perioperative infection and found to be statistically significant in the all
measurement points (all, p<0.01). In multivariate analysis, HCO3 and BUN obtained at
postop day 3 remained as a significant parameter for perioperative infection.