Evaluation of Risk Factors of Surgical Site Infection Following Emergency and Elective Abdominal Operations

Background: Surgical site infection (SSI) is the most common complications of all abdominal operations and the third most frequently reported nosocomial infections in both developed and developing countries. SSIs are associated with substantial discomfort and excessive health care cost. SSIs increase the peri-operative morbidity and mortality, increase the duration of hospital stay, increase post-operative drugs requirements, may need surgical re-interventions and hamper personal or family or economic life. Risks associated with SSIs are related to both host and management factors. However, a vast majority of these infections are preventable. Objective: To evaluate the frequency risk factors associated with SSIs in patients underwent abdominal operations. Methods: The overall SSI rate was 10.1% (12/119), with elective and emergency rates of 7.8% and 12.3%, respectively (p = 0.045). Mean age was 44.3 ± 12.8 years, mean operative time 98.5 ± 25.7 minutes, and mean postoperative stay 7.2 ± 3.1 days. Superficial SSIs accounted for 82.4% (14/17) versus deep SSIs 17.6% (3/17) (χ² = 15.2, p < 0.001). Patients with diabetes (29.5% vs. 15.3%, OR = 2.3, 95% CI: 1.1–4.8, p = 0.028), anemia (26.5% vs. 14.6%, OR = 2.1, p = 0.035), smoking (55.5% vs. 30.8%, OR = 3.1, p = 0.012), and malignancy (18.2% vs. 7.8%, OR = 2.5, p = 0.033) had higher SSI risk. Obesity (10.9% vs. 6.0%, p = 0.052) was borderline. Multivariate analysis identified diabetes (adjusted OR = 2.0, p = 0.041) and smoking (adjusted OR = 2.9, p = 0.015) as independent predictors. Conclusion: Surgical site infections were more common in emergency operations than elective operations. Common risk factors were diabetes mellitus, anemia, chemotherapy or malignancy, hypertension, malnutrition, jaundice & smoking.