Identification of surgical site infection risk factors in the digestive surgery by analysis based on surgical site infection surveillance

Abstract

To describe and investigate risk factors associated with surgical site infection (SSI) in digestive surgery for suppression, we clarified risk factors of SSI development in SSI surveillance. Subjects and Method: SSI surveillance was begun in our institution in 2005. This was a retrospective study of 1,560 patients who underwent digestive surgeries during the period between 2009 and 2013 under the standardized protection. We analyzed risk factors of SSI development and investigated the incidence of SSI for each surgical approach according to surgical technique. The incidence and factors associated with SSI following digestive surgery were investigated by the type of surgical procedures. Results: Univariate analysis revealed that the following factors were associated with a significantly high incidence of SSI: age, diabetes mellitus, malignant disorder, SSI Risk Index Score, wound classification, American Society of Anesthesiologists score (ASA score), construction of stoma, emergency operation, combined resection/surgery, surgical approach (laparotomy/laparoscopic surgery), and operative time. No increase in the incidence of SSI was recognized for the factors of sex, obesity, and smoking. Multivariate analysis revealed that the factors judged to be significant by univariate analysis revealed ASA scores of ≥3 points, malignant disorder, laparotomy, combined resection/surgery, construction of stoma, diabetes mellitus, and age ≥80 were independent risk factors for the incidence of SSI, in descending order of odds ratio. Furthermore, in hepatobiliary and pancreatic surgery and colon surgery, the incidence of SSI decreased significantly when laparoscopic surgery was performed. Conclusion: This study based on the SSI surveillance suggests that the surgical approach is important to suppress the incidence of SSI in patients with a risk of SSI.