Comparative Study of Surgical Site Infections in Elective versus Emergency Abdominal Surgeries: A Retrospective Cohort Study in Odisha.

Introduction: To determine the overall frequency of post-operative surgical site infections (SSIs) among patients undergoing abdominal surgeries in a tertiary care teaching hospital in Odisha, and to compare the incidence of wound infection between elective (Group A) and emergency (Group B) abdominal procedures. Methods: This retrospective cohort study evaluated clinical records of patients admitted to the Department of General Surgery who met predefined inclusion criteria, including patients aged 15 to 70 years of either sex with an American Society of Anaesthesiologists (ASA) physical status grade of 2 or less. To evaluate the operational environment as an independent variable, a comparative cohort design was utilized, allocating 42 cases to Group A (Elective) and 42 cases to Group B (Emergency), totalling N=84 patients. Demographic variables, baseline anthropometric parameters, CDC wound classifications, and surgical wound outcomes were compiled. Primary statistical analysis was conducted using SPSS version 20, employing Pearson Chi-square tests and Fisher's exact test to evaluate the primary outcome of post-operative surgical site infection, with statistical significance established at p < 0.05. Stratified analyses were executed across age, sex, body mass index (BMI), and place of residence to evaluate potential effect modifiers. Results: The statistical evaluation of the total cohort (N=84) revealed an overall post-operative surgical site infection rate of 19.05% (n=16). Group A (elective abdominal surgery=42) demonstrated a post-operative wound infection rate of 9.52% (n=4), whereas Group B (emergency abdominal surgery, n=42) exhibited a significantly higher rate of 28.57% (n=12). Analytical evaluation of the primary outcome demonstrated that emergency status is a significant predictor of post-operative SSI under uncorrected Chi-square (χ² = 4.941, p = 0.026) and Fisher's exact test (p = 0.049). Stratified analyses across subgroups demonstrated that while the higher incidence of SSI in emergency surgeries remains a robust clinical trend, differences within demographic sub-strata did not achieve independent statistical significance due to reduced subgroup sample sizes (p > 0.05). Conclusion: Postoperative wound infection remains a substantial clinical challenge within the evaluated study population in Odisha. Patients undergoing emergency abdominal procedures carry a threefold higher risk of surgical site infections compared to those undergoing planned elective operations, highlighting the need for targeted perioperative care bundles and quality improvement strategies in emergency surgical units.