{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T03:01:19Z","timestamp":1780023679455,"version":"3.53.1"},"reference-count":34,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Emergency surgery (ES) is associated with a significantly higher risk of perioperative complications, including infectious, compared with elective surgery. This study aimed to identify the impact of time to surgical procedure\u00a0and operative duration on infectious complications after ES.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>The 2013\u20132017 American College of Surgeons National Surgical Quality Improvement Program database was utilized to identify all ES patients \u226518 years using the variable \u201cEmergency.\u201d Delayed surgical procedure\u00a0was defined as &gt;12 h and prolonged surgical procedure\u00a0as &gt;2 h. Multivariable logistic regression adjusting for age, comorbidities, and surgical approach was used to investigate the impact of delayed and prolonged surgical procedure\u00a0on postoperative infection, defined as the presence of sepsis, septic shock, surgical site infection (i.e., superficial, deep incisional, and organ space), pneumonia, and urinary tract infection. Sensitivity analyses were performed to examine the same relationship in emergency general surgery (EGS), identified with Current Procedural Terminology codes, and three subsets of EGS patients: exploratory laparotomy, cholecystectomy, and appendectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Out of 4,299,148 patients, 264,213 were included, of which 24,921 (9.4%) had postoperative infections. Patients with infectious complications were more likely to have comorbidities (e.g., obesity, diabetes), an open surgical approach, delayed surgical procedure\u00a0(50.4% vs. 39.4%, p &lt; 0.001), and prolonged surgical procedure\u00a0(31.6% vs. 14.3%, p &lt; 0.001). On multivariable analyses, delayed surgical procedure\u00a0was significantly associated with a 14% higher risk of postoperative infection (adjusted odds ratios [aOR] 1.14; 95% confidence interval [CI] 1.1\u20131.18), and prolonged surgical procedure\u00a0was significantly associated with twice the risk (aOR: 1.99; CI: 1.91\u20132.08). Similarly, delayed and prolonged surgical procedure\u00a0were significantly associated with infectious complications in the subset of EGS patients (aOR: 1.16; CI: 1.11\u20131.22, aOR: 1.91; CI: 1.82\u20132.02, respectively). When examining the 3 sensitivity subsets of patients, prolonged surgical procedure\u00a0was significantly associated with infectious complications in all cohorts (aOR: 1.45; CI: 1.28\u20131.64 in exploratory laparotomy, aOR: 1.93; CI: 1.52\u20132.46 in cholecystectomy, aOR: 2.06; CI: 1.69\u20132.53 in appendectomy), whereas delayed surgical procedure\u00a0was significantly associated with infectious complications only in exploratory laparotomy (aOR: 1.23; CI: 1.13\u20131.33).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Delayed and prolonged surgical procedure\u00a0are independently associated with increased risk of infectious complications in ES patients, including those undergoing EGS procedures. These findings highlight the importance of early and efficient surgical interventions in ES.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10962964261418871","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T03:31:26Z","timestamp":1770089486000},"page":"339-345","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Quick and Short: The Impact of Time to Surgery and Operative Duration on Infection Risk in Emergency Surgery"],"prefix":"10.1177","volume":"27","author":[{"given":"Yasmin","family":"Arda","sequence":"first","affiliation":[{"name":"Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vahe S.","family":"Panossian","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikemsinachi C.","family":"Nzenwa","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John O.","family":"Hwabejire","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"DeWane","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charudutt N.","family":"Paranjape","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George C.","family":"Velmahos","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haytham M.A.","family":"Kaafarani","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481908500219"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2017.03.004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0902.020232"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30696-2"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-015-1321-z"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2014.07.046"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022139"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-0352"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318232db65"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.12.51"},{"issue":"8","key":"e_1_3_2_13_2","first-page":"85","article-title":"CMS unveils proposed list of \u201cno-payment\u201d conditions","volume":"14","year":"2007","unstructured":"CMS unveils proposed list of \u201cno-payment\u201d conditions. 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