Incidence and risk factors of surgical site infection following colorectal surgery in China: a national cross-sectional study

Abstract

Purposes Surgical site infection (SSI) after colorectal surgery is a frequent complication associated with the increase in morbidity, medical expenses, and mortality. To date, there is no nationwide large-scale database of SSI after colorectal surgery in China. The aim of this study was to determine the incidence of SSI after colorectal surgery in China and to further evaluate the related risk factors. Methods Two multicenter, prospective, cross-sectional studies covering 55 hospitals in China and enrolling adult patients undergoing colorectal surgery were conducted from May 1 to June 30 of 2018 and the same time of 2019. The demographic and perioperative characteristics were collected, and the main outcome was SSI within postoperative 30 days. Multivariable logistic regressions were conducted to predict risk factors of SSI after colorectal surgery. Results In total, 1046 patients were enrolled and SSI occurred in 74 patients (7.1%). In the multivariate analysis with adjustments, significant factors associated with SSI were the prior diagnosis of hypertension (OR, 1.903; 95% confidence interval [CI], 1.088–3.327, P = 0.025), national nosocomial infection surveillance risk index score of 2 or 3 (OR, 3.840; 95% CI, 1.926–7.658, P < 0.001), laparoscopic or robotic surgery (OR, 0.363; 95% CI, 0.200–0.659, P < 0.001), and adhesive incise drapes (OR, 0.400; 95% CI, 0.187–0.855, P = 0.018). In addition, SSI group had remarkably increased length of postoperative stays (median, 15.0 d versus 9.0d, P < 0.001), medical expenses (median, 74,620 yuan versus 57,827 yuan, P < 0.001), and the mortality (4.1% versus 0.3%, P = 0.006), compared with those of non-SSI group. Conclusion This study provides the newest data of SSI after colorectal surgery in China and finds some predictors of SSI. The data presented in our study can be a tool to develop optimal preventive measures and improve surgical quality in China.

Incidence and risk factors of surgical site infection following colorectal surgery in Iran: a prospective cohort study

“…An interesting relationship observed in this study was that with increasing age (over 60 years) the risk of developing SSI decreases, although this relationship was not signi cant. In the study of Tie-Ying et al [24], similar to the result of our research, such a result was obtained. Our study showed that the type of intervention for colon cancer was signi cantly associated with SSI, so that patients who had segmental resection with anastomosis had more than twice the risk of SSI compared to patients who had right hemicolectomy.…”

“…Many studies have shown that the incidence of SSI was higher in people with diabetes, but this incidence was not statistically signi cant in diabetic patients [24,25,[33][34][35]. However, our study found that having diabetes signi cantly increased the risk of developing SSI more than doubled.…”

“…Also, the period of time that patients are followed is different in each study [21][22][23]. It should be noted, however, that there are studies around the world that, despite having a single de nition of SSI based on the CDC de nition, have reported different incidence (3.3-19.9%) [20,[24][25][26]. By standard de nition, the results of our study reported a higher incidence of SSI than many other studies.…”

The factors associated with nosocomial infection in elderly hip fracture patients: gender, age, and comorbidity

“…The specific enumeration of comorbid conditions indicated that the most common chronic diseases consisted of a major part of the comorbidities in elderly patients with hip fracture. Additionally, chronic respiratory disease, diabetes mellitus, hypertension, and cerebrovascular disease, which were the top five most frequent, have been found to be associated with post-operative infection in both the surgical site and other organs [14,18,20,27,35,36]. Moreover, some diseases which were not in the top five most frequent, such as anemia, malignant tumour, and cardiac failure, have also have been found to be associated with post-operative infections [35,37,38].…”

The Effectiveness of Superficial Drain to Reduce Surgical Site Infection in Colorectal Surgery

“…Similar findings were reported by the studies of Zhang et al and Alkaaki et al, which reported that emergency surgeries had a fivefold increase in the risk of development of SSI compared to elective surgeries. This could be explained by the lack of bowel prep in emergency colorectal surgeries, thus, increasing the likelihood of bacterial translocation [5,14].…”