Operating room-related risk factors for surgical site infection in general surgeries: A retrospective cohort study

This study aims to identify modifiable operating room-related risk factors for surgical site infection (SSI) using multivariate logistic regression analysis. This retrospective cohort study was conducted at a tertiary hospital between July 2021 and September 2023, enrolling patients who underwent various general surgical procedures and met the predefined inclusion criteria. Clinical, demographic, intraoperative, and postoperative data were collected from medical records. Independent risk factors for SSI were identified via multivariate logistic regression. Among 479 patients, 60 (12.5%) developed SSI. Multivariate analysis identified several independent risk factors: elevated body mass index (OR = 1.12, 95% CI: 1.05-1.19, P <.001), diabetes mellitus (OR = 2.10, 95% CI: 1.14-3.88, P = .017), emergency surgery (OR = 3.15, 95% CI: 1.58-6.27, P = .001), prolonged surgical duration ≥ 2 hours (OR = 2.42, 95% CI: 1.30-4.52, P = .005), conventional operating room environment (OR = 2.20, 95% CI: 1.20-4.03, P = .011), intraoperative personnel changes (OR = 3.50, 95% CI: 1.85-6.62, P <.001), and poor compliance with infection control measures including instrument sterilization (OR = 4.45, 95% CI: 2.13-9.28, P <.001) and hand hygiene (OR = 3.18, 95% CI: 1.71-5.93, P <.001). Our findings highlight modifiable intraoperative factors associated with SSI, which may inform future preventive strategies. However, prospective validation is warranted to assess their clinical impact. Several modifiable operating room-related factors significantly increase SSI risk. Several modifiable OR-related factors were significantly associated with SSI risk. These insights may inform future preventive efforts, but further prospective validation is needed.