Risk factors analysis of surgical site infections in postoperative colorectal cancer: a nine-year retrospective study

Abstract

Background Colorectal cancer (CRC) patients undergoing surgery are at a high risk of developing surgical site infections (SSIs), which contribute to increased morbidity, prolonged hospitalization, and escalated healthcare costs. Understanding the incidence, risk factors, and impact of SSIs is crucial for effective preventive strategies and improved patient outcomes. Methods This retrospective study analyzed data from 431 CRC patients who underwent surgery at Huangshan Shoukang Hospital between 2014 and 2022. The clinical characteristics and demographic information were collected. The incidence and impact of SSIs were evaluated, and independent risk factors associated with SSIs were identified using multivariable logistic regresison. A nomogram plot was constructed to predict the likelihood of SSIs occurrence. Results The overall incidence rate of SSIs was 7.65% (33/431). Patients with SSIs had significantly longer hospital stays and higher healthcare costs. Risk factors for SSIs included elevated Body Mass Index (BMI) levels (odds ratio, 1.12; 95% CI, 1.02—1.23; P = 0.017), the presence of diabetes (odds ratio, 3.88; 95% CI, 1.42 – 9.48; P = 0.01), as well as specific surgical factors such as open surgical procedures (odds ratio, 2.39; 95% CI [1.09; 5.02]; P = 0.031), longer surgical duration (odds ratio, 1.36; 95% CI [1.01; 1.84]; P = 0.046), and the presence of a colostomy/ileostomy (odds ratio, 3.17; 95% CI [1.53; 6.62]; P = 0.002). Utilizing multivariable regression analysis, which encompassed factors such as open surgical procedures, the presence of diabetes and colostomy/ileostom, the nomogram plot functions as a visual aid in estimating the individual risk of SSIs for patients. Conclusions Risk factors for SSIs included higher BMI levels, the presence of diabetes, open surgical procedures, longer surgical duration, and the presence of colostomy/ileostomy. The nomogram plot serves as a valuable tool for risk assessment and clinical decision-making.

Risk factors for surgical site infection after percutaneous endoscopic lumbar discectomy

“…Numerous systematic reviews and meta‐analyses describe the link between diabetes and SSI 27–29 . Elevated blood glucose levels not only inhibit natural wound healing mechanisms by reducing collagen synthesis and disrupting angiogenesis, but also create an environment conducive to bacterial proliferation 30 .…”

“…Numerous systematic reviews and meta‐analyses describe the link between diabetes and SSI. 27 , 28 , 29 Elevated blood glucose levels not only inhibit natural wound healing mechanisms by reducing collagen synthesis and disrupting angiogenesis, but also create an environment conducive to bacterial proliferation. 30 Pennington et al 27 demonstrated that persistent postoperative hyperglycaemia is a risk factor for deep wound infection after spinal surgery.…”

Efficacy and safety of oral probiotic supplementation in mitigating postoperative surgical site infections in patients undergoing colorectal cancer surgery: A systematic review and meta‐analysis

“…SSIs contribute to prolonged periods of postoperative fever, extended hospital stays and an increase in overall healthcare costs. The pathophysiological mechanisms underlying SSIs are multifaceted and often include microbial colonization at the surgical site, impaired local and systemic immune responses and a disruption in the gut microbiota, among other factors 3,4 …”

“…The pathophysiological mechanisms underlying SSIs are multifaceted and often include microbial colonization at the surgical site, impaired local and systemic immune responses and a disruption in the gut microbiota, among other factors. 3,4 Antibiotic prophylaxis is conventionally employed to minimize the risk of SSIs. While antibiotics are undeniably efficacious in curtailing infections, their usage is not without drawbacks.…”

“…The pathophysiological mechanisms underlying SSIs are multifaceted and often include microbial colonization at the surgical site, impaired local and systemic immune responses and a disruption in the gut microbiota, among other factors. 3 , 4 …”