Outcomes are Local: A Cross Sectional Patient Specific Study of Risk Factors for Surgical Site Infections in Major Abdominal Surgeries

Abstract

Background: Surgical Site Infections (SSI) after elective/emergency laparotomy contributes to postoperative morbidity, mortality and resource utilization. Risk factors related to abdominal SSIs are well known. Nevertheless, National data guide efforts to improve efficiency, which cannot identify specific organizational risk factors. Aim and Objectives: To describe the prevalence and risk factors associated with SSI in patients undergoing laparotomy. Material and Methods: Descriptive, observational study of elective/emergency laparotomy patients uses institutional data from 2017-2019. Univariate and Multivariable logistic regression identified risk factors associated with SSI development. Results: Of 393 patients studied. 88 developed SSI (superficial 19.60%, deep 2.30%, organ space 0.50%), age (40-60 years), males, Body Mass Index (BMI) >25, smoking, diabetes, alcohol, higher wound class, low hematocrit, low serum albumin,Longer duration of surgery were associated with increased SSI rate. Associated co-morbidities, Low hematocrit and higher duration of surgery were significant independent risk factors (p<0.05). Conclusion: Institutional SSI modeling shows that many previously suggested nationally defined risk factors do not contribute to SSI, at our institution. Identifying SSI's institutional contextual predictors, rather than relying on external data assumptions, is a vital endeavor to promote quality improvements and maximize the value of quality investments.

Keywords

• surgical site infection
• abdominal surgeries
• risk factor
• centre for disease control