Surgical Site Infection After Emergency Abdominal Surgery in China: A Multicenter Prospective Study

Abstract

Background 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 status of SSI after EAS in China and discuss its risk factors. Materials and Methods 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 treatment costs. Univariate and multivariate logistic regression were used to analyze the risk factors.Results A total of 953 patients (age 48.8 ± 17.9 years, 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 = 0.022) was a protective factor. Conclusion 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.

Incidence and risk factors of surgical site infections and related antibiotic resistance in Freetown, Sierra Leone: a prospective cohort study

“…Nonetheless, similar to other studies [ 4 , 15 , 17 – 19 ], we identified several predictors of SSI, including ASA score ≥ 2, male sex, preoperative admission for more than 24 h, duration of surgery ≥ 2 h, administration of general anaesthesia, contaminated wound type, and elevated fasting blood glucose. Worthy of note is that some of these risk factors reflect a common scenario of the severe premorbid state of many patients in Sierra Leone and thus implies that early health-seeking behavior is critical to the prevention of surgical site infections.…”

El efecto del tipo de traslado del paciente al quirófano sobre la ISQ: inquietudes frente a evidencia

“…Surgical site infection is one of the most common complications after an emergency abdominal surgery 10,20 . When the distribution of the surgery types between the groups was compared, a statistically significant difference was found in our study.…”

Preventing surgical site infection after cholecystitis by postoperative antibiotic: A randomized controlled trial study

“…On the other hand, AC is one of the most common surgical problems treated by surgery [9]. The incidence of SSI is higher in gastrointestinal surgeries compared to other operations [10,11] and prevention must be considered. In this regard, two strategies have been proposed namely preoperative prophylaxis and postoperative antibiotics.…”