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Development and validation of risk prediction score for incisional surgical site infection after appendectomy

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Abstract

Surgical site infection (SSI) is a challenging and resource-consuming healthcare problem. Predicting the onset of SSI beforehand can help prevent or minimize its incidence. The present study aimed to determine the independent predictors of incisional SSI after open appendectomy using a multivariate analysis and to establish a predictive risk score of SSI after appendectomy. Records of eligible patients who underwent open appendectomy were reviewed. The characteristics and treatment outcomes of patients were collected and analyzed. Significant association between different variables and SSI after appendectomy was examined by univariate analysis. Then, variables with a significant association with SSI were entered into a multivariate binary logistic regression analysis to determine the significant independent predictors of SSI. The study included 343 patients (51.3% female). Incisional SSI was recorded in 44 (12.8%) patients. Univariate analysis revealed five parameters with a significant association with SSI, including BMI > 30 kg/m2 (p < 0.0001), diabetes mellitus (DM) (p = 0.0001), total leukocyte count (p = 0.04), free intraperitoneal fluid (p < 0.0001), and perforated/gangrenous appendicitis (p < 0.0001). After identifying four significant independent predictors of incisional SSI by binary logistic regression analysis, a predictive risk score was developed. The independent predictors of SSI were DM (OR = 6.05, p = 0.005), free intraperitoneal fluid (OR = 6.94, p = 0.0001), obesity (OR = 8.94, p = 0.0001), and perforated/gangrenous appendicitis (OR = 24.64, p = 0.0001). Four independent predictors of incisional SSI after open appendectomy were found after multivariate analysis. A predictive risk score of SSI was developed and included obesity, DM, free intraperitoneal fluid, and perforated/gangrenous appendicitis as predictors of SSI.

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Authors and Affiliations

  1. Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt

    Sameh Hany Emile, Ahmed Hossam Elfallal & Samy Abbas Elbaz

  2. Vascular Surgery Department, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt

    Ahmed Magdy Elmetwally

Authors
  1. Sameh Hany Emile
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  2. Ahmed Hossam Elfallal
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  3. Samy Abbas Elbaz
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  4. Ahmed Magdy Elmetwally
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Contributions

SH designed the study, contributed to data collection and analysis and writing of the manuscript. AHE contributed to data collection and analysis and writing parts of the manuscript. SAE participated in data interpretation, and revising the manuscript. AME contributed to data interpretation, drafting and critical revision of the manuscript.

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Correspondence to Sameh Hany Emile.

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Ethical approval for the study was obtained from the Institutional Review Board (IRB) of our institution.

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All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Emile, S.H., Elfallal, A.H., Elbaz, S.A. et al. Development and validation of risk prediction score for incisional surgical site infection after appendectomy. Updates Surg 73, 2189–2197 (2021). https://doi.org/10.1007/s13304-020-00944-x

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  • DOI: https://doi.org/10.1007/s13304-020-00944-x

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