Key result
Diabetes is linked to a ~119% higher surgical site infection risk after colorectal surgery.
Why the study?
Surgical site infections prolong hospital stays, increase costs, and endanger lives, prompting this investigation into the incidence, risk factors, and microbiology of SSI after colorectal surgery.
Cross-Sectional (n=3,302)
No
Odds Ratio: 2.19 (95% CI 1.42–3.37)
Absolute Event Rate: 10.7% vs 5.8%
p-value: p=<0.001
Identifying and modifying perioperative risk factors, such as utilizing laparoscopic surgery and preoperative bowel preparation, can significantly reduce the incidence of surgical site infections after colorectal surgery.
Background The occurrence of surgical site infection (SSI) can prolong the postoperative hospital stay, increase the economic burden of patients, and even endanger their lives. The purpose of this study was to investigate the incidence, risk factors, and microbiology of SSI after colorectal surgery (CRS) and to provide a basis for the prevention and control of SSI. Methods A single-center, prospective, cross-sectional study of adult patients undergoing CRS was conducted from 2010–2019. Univariate and multivariate logistic regression models were used to collect and analyze demographic information, hospital characteristics, and potential perioperative risk factors of SSI. Results A total of 3,302 eligible patients were included in this study, with 213 cases experiencing SSIs, resulting in an infection rate of 6.45%. Notably, the incidence of SSI decreased from 13.33% in 2010 to 3.56% in 2019 (Ptrend < 0.001). Escherichia coli accounted for the majority of isolated microorganisms (37.09%), with 49 strains exhibiting resistance to one or more antibiotics (35.25%). Multivariate analysis showed that diabetes, anastomosis leakage, wound classification (contaminated/dirty), operation duration, blood loss greater than 200 ml, and NNIS risk index score for 2 or 3 were independent risk factors. Conversely, laparoscopic approach, preoperative bowel preparation and preoperative albumin levels emerged as protective factors against SSI after CRS. Furthermore, compared to non-SSI patients, SSI patients had a significantly higher 30-day mortality rate following surgery (0.23% vs. 2.35%, p < 0.05). Conclusion SSI after CRS was susceptible to many factors, and the pathogen of SSI was mainly Escherichia coli. In clinical practice, measures such as correcting preoperative hypoproteinemia, choosing laparoscopic surgery, preoperative bowel preparation and shortening the duration of surgery should be taken to reduce the incidence of SSI.
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Sun et al. (2023) conducted a cross-sectional in Colorectal surgery (n=3,302). Diabetes vs. No diabetes was evaluated on Incidence of surgical site infection (SSI) within 30 days after surgery (OR 2.19, 95% CI 1.42-3.37, p=<0.001). Diabetes, anastomosis leakage, contaminated/dirty wounds, prolonged surgery, blood loss >200 ml, and higher NNIS scores were independent risk factors for surgical site infection after colorectal surgery, with diabetes associated with a twofold increased risk (OR 2.19).
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