A PROGNOSTIC MODEL FOR SURGICAL SITE INFECTION

The aim of the study is to determine the incidence of surgical site infection (SSI), risk factors for its development and to evolve a prognostic model for stratifying patients according to its level. Materials and Methods. The study was conducted at Ulyanovsk Regional Clinical Hospital and Ulyanovsk Regional Clinical Oncology Center. A total of 1,500 planned laparotomies were performed (database registration certificate No. 2024623300) including 190 gastrectomies with D2 lymph node dissection, 882 colon resections, and 428 total hysterectomies. A retrospective analysis of the results was carried out during the postoperative period according to a single protocol. StatTech v. 4.5.0 (Stattech, Russia) and SPSS 26 for Mac (IBM Corp.), R Statistics 3.6.1 were used for statistical analysis of the study results. Results. The incidence of SSI was 4.93 % (74/1500). There were 12 fatal outcomes (16.2 %) in the group with SSI and 15 ones (1.1 %) in the group without SSI. The most significant factors influencing the development of postoperative infectious complications in the surgical site are age (p=0.007), diabetes mellitus (p<0.001), subcutaneous fat thickness (p<0.001), neutrophil-to-lymphocyte ratio (p<0.001), body mass index (p<0.001), and surgery duration (p<0.001). Multivariate analysis showed that only the following parameters influence the SSI development after laparotomy: colon surgery (OR 8.66 (95 % CI 3.74–21.7); diabetes mellitus (OR 9.36 (95 % CI 4.22–21.65); BMI (OR 1.55 (95 % CI 1.42–1.71) and neutrophil-to-lymphocyte ratio (OR 0.07 (95 % CI 0.03–0.13). A prognostic model for the risk of SSI development was created and programmed as an HTML application using the JavaScript programming language. Conclusion. The incidence of postoperative infectious complications in the surgical site after standard midline laparotomy for elective surgery was 4.93 % (74/1500). The authors created a prediction model to stratify patients according to the risk of SSI development.