Risk Factors Affecting Surgical Site Infections in Colorectal Cancer Surgery: Analysis of National Multicenter Data

Aim: Surgical site infections (SSIs) are a significant complication in colorectal cancer (CRC) surgery. This study investigates the risk factors affecting SSI in CRC using national data. Method: Prospective data collected from the Turkish Colon and Rectum Surgery Association Colorectal Cancer Database were retrospectively analyzed. A total of 1,216 patients who underwent surgery between July 2018 and March 2022 were included in the study. Factors affecting SSI were evaluated using multivariate analysis. Results: The total SSI rate was 13.98% (9.29% superficial, 2.06% deep, and 2.63% organ/space). In univariate analyses, the presence of SSI was associated with several factors, including high body mass index (BMI), advanced TNM stage, presence of coronary artery disease (CAD), presence of concurrent malignancy, high American Society of Anesthesiologists score, receiving neoadjuvant therapy, emergency operation, open surgery, hand anastomosis, anastomosis configuration, iatrogenic ureter injury, simultaneous prostate resection, postoperative blood transfusion, evisceration, prolonged ileus, anastomotic leak, urinary fistula, urinary retention, postoperative bleeding, postoperative pneumonia, postoperative renal failure, reoperation and need for readmission. In multivariate analysis, high BMI [odds ratio (OR): 1.51, 95% confidence interval (CI): 1.02-2.21, p=0.0354], advanced stage disease (OR: 2.06, 95% CI: 1.38-3.07, p=0.0004), CAD (OR: 1.85, 95% CI: 1.14-3.01, p=0.0120), concurrent malignancy (OR: 3.35, 95% CI: 1.64-6.84, p=0.0009), receiving neoadjuvant therapy (OR: 1.76, 95% CI: 1.18-2.61, p=0.0048), emergency operation (OR: 3.26, 95% CI: 1.84-5.78, p<0.0001), postoperative blood transfusion (OR: 2.44, 95% CI: 1.67-3.56, p<0.0001) were identified as independent risk factors. Conclusion: SSI following CRC is still a problem in our country. In this study, risk factors similar to those reported in the literature were detected.