Prospective multicenter study on the incidence of surgical site infection after emergency abdominal surgery in China

Abstract

There is still a lack of relevant studies on surgical site infection (SSI) after emergency abdominal surgery (EAS) in China. This study aims to understand the incidence of SSI after EAS in China and discuss its risk factors. All adult patients who underwent EAS in 47 hospitals in China from May 1 to 31, 2018, and from May 1 to June 7, 2019, were enrolled in this study. The basic information, perioperative data, and microbial culture results of infected incision were prospectively collected. The primary outcome measure was the incidence of SSI after EAS, and the secondary outcome variables were postoperative length of stay, ICU admission rate, ICU length of stay, 30-day postoperative mortality, and hospitalization cost. Univariate and multivariate logistic regression were used to analyze the risk factors. The results were expressed as the odds ratio and 95% confidence interval. A total of 953 patients [age 48.8 (SD: 17.9), male 51.9%] with EAS were included in this study: 71 patients (7.5%) developed SSI after surgery. The main pathogen of SSI was Escherichia coli (culture positive rate 29.6%). Patients with SSI had significantly longer overall hospital (p < 0.001) and ICU stays (p < 0.001), significantly higher ICU admissions (p < 0.001), and medical costs (p < 0.001) than patients without SSI. Multivariate logistic regression analysis showed that male (P = 0.010), high blood glucose level (P < 0.001), colorectal surgery (P < 0.001), intestinal obstruction (P = 0.045) and surgical duration (P = 0.007) were risk factors for SSI, whereas laparoscopic surgery (P < 0.001) was a protective factor. This study found a high incidence of SSI after EAS in China. The occurrence of SSI prolongs the patient's hospital stay and increases the medical burden. The study also revealed predictors of SSI after EAS and provides a basis for the development of norms for the prevention of surgical site infection after emergency abdominal surgery.

Risk Factors for Surgical Site Infections in Patients Undergoing Emergency Surgery: A Single-centre Experience

“…Although the included studies covered a wide range of surgical procedures, based on their pooled analysis, the authors showed that the likelihood of developing SSI was twice as high among individuals who underwent surgical procedures with protracted operative times. Lastly, Li et al also showed that surgical duration >120 minutes was independently associated with development of SSI in patients undergoing emergency abdominal surgery (18). Therefore, the adoption of measures such as improved operative planning, whenever possible, is of paramount importance.…”

Prevalence of Wound Infection in Patients Undergoing Elective or Emergency Abdominal Surgery

“…Several of studies illustrated that the rate of surgical site infection 7 to 33 percent. [21,22] In present study total one hundred and fifty patients whom were undergoing laparotomy treatment due to intra-abdominal cavity and other perforated infections were included and all of them were equally divided 75 patients in each group. Group A received laparotomy with post-operative drain and Group B received no drain placement.…”

Incidencia de infección del sitio quirúrgico en el Servicio de Cirugía I, hospital Dr. Miguel Pérez Carreño. 2019-2021. Estudio observacional

“…Esta patología es un factor de riesgo para ISQ ya existe una alteración de la barrera intestinal, debido al ayuno prolongado y la dilatación de la luz intestinal, independientemente de si hay apertura del tracto gastrointestinal, condicionando la traslocación bacteriana. (13) El retraso en el manejo quirúrgico de los pacientes con obstrucciones intestinales constituye un factor agravante que predispone a la aparición de complicaciones e ISQ.…”