Incisional surgical site infection in colorectal surgery patients.

Abstract

BACKGROUND: Knowledge of specific risk factors for incisional Surgical Site Infection (SSI) is essential to create a specific SSI risk stratification index for colorectal surgery patients. OBJECTIVE: Identify factors increasing the risk of incisional SSI that lead to the development of a more efficient tool for predicting and comparing surgical site infection rates among surgeons and institutions performing the same type of procedure for colorectal surgery patients. MATERIAL AND METHOD: The authors conducted a prospective incisional SSI surveillance in 229 consecutive patients who underwent open colon and rectal resections performed in Phramongkutklao Hospital between October 1, 2008 and September 30, 2010. Independent risk factors for SSIs were identified by multivariate analysis. RESULTS: The present study identified six independent risk factors significantly associated with a higher risk of incisional SSI that included Body mass index (BMI) > 30 (Odd ratio (OD) = 4.4; 95% confidence interval (CI) = 1.235-15.502; p = 0.022), hypoalbuminemia (< 3.5 g/dl) (Odd ratio (OR) = 2.8; 95% confidence interval (CI) = 1.003-7.587; p = 0.049), Hartmann's procedure (Odd ratio (OR) = 2.6; 95% confidence interval (CI) = 1.037-6.729; p = 0.042), postoperative hypotension, (Odd ratio (OR) = 2.3; 95% confidence interval (CI) = 1.043-5.268; p = 0.039) and postoperative hypothermia (Odd ratio (OR) = 5.6; 95% confidence interval (CI) = 1.112-28.482; p = 0.037). CONCLUSION: Risk factors identified in the present study can be considered for creating a specific incisional SSI risk stratification index for colorectal surgery patients. This specific risk stratification index will be a more efficient tool for predicting and comparing SSI rates among surgeons and institutions.