Risk factors for surgical site infection in women undergoing hysterectomy for gynecological cancers: a retrospective study

Background Hysterectomy is a common surgery performed in women. Most patients with gynecological cancers (GCs) undergo hysterectomy along with extensive resection and are prone to surgical site infections (SSIs). However, the risk factors for SSIs in this population remain unclear. This study focuses on this issue. Methods Patients who underwent hysterectomy for GCs between January 2021 and December 2025 were selected from the electronic medical records of a single institution. The patients were classified into the non-SSI and SSI groups based on the occurrence of SSIs. Uni- and multivariate logistic regression analyses were used to evaluate risk factors among patient demographics and clinical characteristics. Results In total, 558 patients were included in this study. The non-SSI and SSI groups included 468 and 90 patients, respectively. Univariate analysis indicated significant differences in six factors: diabetes mellitus (DM), intraoperative blood transfusion (IBT), intraoperative blood loss (IBL), surgical time, cervical cancer surgery, and ovarian cancer surgery ( P < 0.05). Further multivariate logistic regression analysis showed that DM, IBT, IBL, surgical time, cervical cancer surgery, and ovarian cancer surgery were independent risk factors for SSIs. Receiver operating characteristic curve analysis of IBL and surgical time showed areas under the curve of 0.9420 and 0.8984, respectively. Conclusions DM, IBT, greater IBL, extended surgical time, cervical cancer surgery, and ovarian cancer surgery were found to be risk factors for SSIs in patients undergoing hysterectomy for the treatment of GCs. The accurate identification of high-risk patients is critical to guide perioperative care and reduce SSI-related morbidity.