Surgical site infection following colorectal surgeries: Incidence, healthcare resource utilisation and risk factors in a major referral hospital in Malaysia

Surgical site infections (SSI) remain a significant clinical and economic burden, particularly in colorectal surgeries. Despite the high volume of surgeries performed in Malaysia, there is limited local data on the incidence, risk factors, and cost implications of colorectal SSI. This study aimed to address this gap by evaluating the burden of SSI in a Malaysian public hospital setting. A retrospective cohort study was conducted using data from a Malaysian colorectal referral centre for central region, between January 1, 2023, and June 30, 2024. Adult patients aged 18–75 years who underwent inpatient colorectal surgery were included, with 30-day postoperative follow-up. Descriptive analysis was performed using clinical and resource utilisation data obtained from electronic medical records. A total of 125 colorectal surgeries were performed during the study period, with 42 patients developing SSI, yielding an incidence rate of 33.6 %. Patients with SSI incurred higher healthcare costs, with mean index hospitalisation costs of RM 8978 (RM 1 = 0.23 USD) compared to RM 6057 for those without SSI. Post-discharge costs were also higher in the SSI group (RM 937 vs RM 341). The total direct cost attributable to SSI was RM 166,286, with key cost drivers being laboratory investigations (46 %) and facility-related costs (30 %). The high incidence and cost burden of SSI in colorectal surgery highlight the need for improved infection prevention. Enhancing adherence to prophylactic guidelines, expanding Enhanced Recovery After Surgery (ERAS) protocol implementation and strengthening surveillance systems are critical to improving outcomes and reducing costs.