Risk factors for surgical site infection: An observational study in appendectomies performed in a community hospital in Qatar

Background: Surgical site infections (SSIs) after appendectomies constituted a significant patient safety issue and impacted the efficiency of healthcare. Various risk factors had been linked to SSI after appendectomies, including risk to patients and procedures, and compliance with infection control practices. This study aimed at identifying the risk factors for SSI in appendectomies due to acute appendicitis in a single facility in Qatar. Methods: A historical observational study of appendectomies performed from January 2013 to February 2023 at a single facility in Qatar was conducted. Demographics, surgical procedure data, compliance with antibiotic prophylaxis, and histopathological findings were recorded from the patient’s electronic medical records. Results: A total of 2377 appendectomies and 52 SSIs were described, mainly in male patients (93.3%) with a mean age of 32.4 years and non-complicated appendicitis (66.7%). SSI risk was 3.86 times higher when appendicitis was perforated in comparison to other appendicitis types [odds ratio (OR) = 3.86; 95% confidence interval (95% CI) OR 1.93–7.70]. Procedures longer than 81 minutes had 4.84 times more SSI risk (OR = 4.84; 95% CI 2.25–10.42), the improper timing of antibiotic prophylaxis had 5.97 times higher SSI risk (OR = 5.97; 95% CI 1.10–32.56), and the improper antibiotic selection had 9.08 times higher SSI risk (OR = 9.08; 95% CI 1.81–45.42). Conclusion: This study identifies the risk factors linked to SSI risk, including perforated appendectomies, longer surgical procedures, and improper timing and selection of antibiotic prophylaxis. The infection control program should focus on interventions to improve compliance with antibiotic prophylaxis and evaluate additional strategies to minimize the SSI risk in complicated appendicitis.