Risk Factors For Abdominal Surgical Site Infection In Gannan Region

Objective:Surgical site infection(SSI)is one of the most common complications after surgery,and SSI is more common in abdominal surgery than other sites.The occurrence of SSI brings patients postoperative pain,prolonged hospital stay,postoperative recovery,incisional hernia and other related complications,and there are different risk factors for the occurrence of SSI in different countries and regions.This study aimed to provide a clinical basis for the prevention of abdominal surgical site infection by investigating the risk factors for SSI after single-center abdominal surgery in a medical institution in Gannan Province.Methods:The study subjects selected patients who were hospitalized for abdominal surgery in the First Affiliated Hospital of Gannan Medical College from March 2022 to October 2022,and began to record patient-related information after admission,and real-time recording of patient-related data through the hospital medical order system,electronic medical record system and daily routine ward rounds,followed up for at least 1 month after surgery,and follow-up after discharge through telephone follow-up,outpatient review follow-up and readmission treatment.The primary outcome was whether SSI occurred within 30 days of surgery,and secondary data were total hospital stay,days postoperative hospital stay,total hospital costs,postoperative antibiotic costs,and microbial culture results for infection at the surgical site.The factors that affected SSI collected included patient factors including gender,age,smoking,hypertension,diabetes,preoperative hemoglobin,preoperative albumin,American Society of Anesthesiologists(ASA)grade,body mass index(BMI);Surgical factors include time to surgery,mode of surgery(laparoscopic or laparotomy),type of surgery(elective,limited,or emergency surgery),preoperative mechanical bowel preparation,preoperative intravenous prophylactic antibiotics,incision classification,type of suture,incision protector.The t-test was used for the comparison between quantitative data groups,and Chi-square test was used for qualitative data,univariate analysis was performed first,and the significant variable(P<0.05)in univariate analysis was input into the multivariate logistic regression model for multivariate analysis.Results:1.A total of 612 patients met the inclusion criteria,of which 62 developed surgical site infection,with an incidence of 10.13%;There were 21 cases of superficial incisional surgical site infection,accounting for 33.87%;There were 20 cases of deep incisional surgical site infection,accounting for 32.26%;There were 21 cases of organ/space surgical site infection,accounting for 33.87%.2.Among the 62 patients with surgical site infection,41 patients had positive culture results,and the positive rate was 67.21%.57 strains of microorganisms were cultured,among which the top two bacteria were 21 strains of Escherichia coli(36.84%)and 11 strains of Enterococcus faecal(19.30%).3.The total number of days of hospitalization,postoperative hospitalization,total hospitalization cost and postoperative antibiotic use cost of patients with SSI after abdominal surgery were higher than those of patients without SSI,and there was a statistically significant between the two(P<0.05).4.Univariate analysis found that preoperative anemia,preoperative low albumin,ASA score,operation time,surgical method,surgical type,preoperative intestinal preparation,incision classification,and suture type were associated with the occurrence of SSI after abdominal surgery(P<0.05),and multivariate logistic regression analysis found that surgical time,surgical method,ASA score,incision classification,and suture type were independent influencing factors of SSI after abdominal surgery.Conclusions:1.The incidence of SSI for abdominal surgery in this center is 10.13%,and the two most common bacteria in SSI cultures are Escherichia coli and Enterococcus faecalis.2.Patients with SSI after abdominal surgery have significantly higher treatment time and hospital costs than patients without SSI.3.Multivariate logistic regression analysis found that surgery time,surgical method,ASA score,incision classification and suture type were independent influencing factors for the occurrence of SSI after abdominal surgery,and more attention should be paid to patients with these influencing factors to reduce the occurrence of SSI after abdominal surgery.4.This study is a single-center cross-sectional study,to prevent the occurrence of SSI after abdominal surgery to provide single-center relevant research evidence,in order to better prevent the occurrence of SSI after abdominal surgery,it is necessary to combine the local situation,to start from multiple aspects,so as to better prevent the occurrence of SSI after abdominal surgery.