Identification of Risk Factors and Phenotypes of Surgical Site Infection in Patients After Abdominal Surgery

Abstract

Objectives: We aimed to determine the current incidence rate and risk factors for surgical site infection (SSI) after abdominal surgery in China and to further demonstrate the clinical features of patients with SSI. Background: Contemporary epidemiology and clinical features of SSI after abdominal surgery remain poorly characterized. Methods: A prospective multicenter cohort study was conducted from March 2021 to February 2022; the study included patients who underwent abdominal surgery at 42 hospitals in China. Multivariable logistic regression analysis was performed to identify risk factors for SSI. Latent class analysis (LCA) was used to explore the population characteristics of SSI. Results: In total, 23,982 patients were included in the study, of whom 1.8% developed SSI. There was a higher SSI incidence in open surgery (5.0%) than in laparoscopic or robotic surgeries (0.9%). Multivariable logistic regression indicated that the independent risk factors for SSI after abdominal surgery were older age, chronic liver disease, mechanical bowel preparation, oral antibiotic bowel preparation, colon or pancreas surgery, contaminated or dirty wounds, open surgery, and colostomy-/ileostomy. LCA revealed 4 subphenotypes in patients undergoing abdominal surgery. Types α and β were mild subclasses with a lower SSI incidence; whereas types γ and δ were the critical subgroups with a higher SSI incidence, but their clinical features were different.Conclusions: LCA identified 4 subphenotypes in patients who underwent abdominal surgery. Types γ and δ were critical subgroups with a higher SSI incidence. This phenotype classification can be used to predict SSI after abdominal surgery.

Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer

“…Patients with colorectal cancer undergoing abdominal surgery have a higher incidence of unplanned postoperative reoperation compared to other general surgical procedures[ 25 ] due to their susceptibility to incisional and abdominal infections, venous thromboembolism, and perioperative complications[ 26 , 27 ]. In addition, the inherent necessity of reconstructing abdominal organs during colorectal surgery increases the likelihood of postoperative complications, thereby increasing the likelihood of subsequent reoperations.…”

Risk factors for surgical site infection in patients undergoing obstetrics and gynecology surgeries: A meta-analysis of observational studies

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