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Risk factors for surgical site infection in a teaching hospital: a prospective study of 1,138 patients

Authors Cheng K, Li J, Kong Q, Wang C, Ye N, Xia G

Received 6 April 2015

Accepted for publication 30 June 2015

Published 14 August 2015 Volume 2015:9 Pages 1171—1177


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5

Editor who approved publication: Dr Naifeng Liu

Keping Cheng, Jiawei Li, Qingfang Kong, Changxian Wang, Nanyuan Ye, Guohua Xia

Department of Infection Control, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu Province, People’s Republic of China

Background: The purpose of this study was to identify risk factors for surgical site infection (SSI) in a teaching hospital.
Methods: A prospective study was initiated to investigate risk factors for SSI at a university-affiliated tertiary care center from July 2013 to December 2014. The chi-square test for categorical variables was used to determine the significance of association, whereas the multivariate logistic regression model was used to examine independent risk factors for SSI.
Results: A total of 1,138 patients met the inclusion criteria, in whom 36 cases of infection occurred during the hospitalization period and two cases occurred after discharge. Univariate analysis showed that SSI was associated with the type of operation, wound classification, volume of blood loss, blood transfusion, American Society of Anesthesiology score before surgery, risk index, duration of surgery, diabetes, cancer, gastrointestinal catheter, urinary catheter, postoperative drainage, and preprocedural white blood cell count. Multivariate analysis identified six independent parameters correlating with the occurrence of SSI: diabetes (odds ratio [OR] 6.400; 95% confidence interval [CI] 2.582–15.866; P=0.000); cancer (OR 2.427; 95% CI 1.028–5.732; P=0.043); preprocedural white blood cell count more than 10×109/L (OR 6.988; CI 3.165–15.425; P=0.000); wound classification (clean contaminated [OR: 7.893; CI: 2.244–27.762; P=0.001]; contaminated [OR: 7.031; CI: 1.652–29.922; P=0.008]; dirty [OR: 48.778; CI: 5.418–439.164; P=0.001]); operative duration more than 120 minutes (OR 4.289; CI 1.773–10.378; P=0.001); and postoperative drainage (OR 3.957; CI 1.422–11.008; P=0.008).
Conclusion: Our data suggest that all these risk factors could be regarded as potential indicators of SSI and that relevant preventive measures should be taken to reduce SSI and improve patient outcomes.

Keywords: wound classification, surgical site infection, nosocomial infection, risk factors

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