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Risk factors for surgical site infection following colorectal resection: a multi-institutional study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Introduction

Surgical site infection (SSI) is an infection occurring in an incisional wound within 30 days of surgery and significantly affects patients undergoing colorectal surgery. This study examined a multi-institutional dataset to determine risk factors for SSI following colorectal resection.

Methods

Data on 386 patients who underwent colorectal resection in three institutions were accrued. Patients were identified using a prospective SSI database and hospital records. Data are presented as median (interquartile range), and logistic regression analysis was used to identify risk factors.

Results

Patients (21.5 %) developed a postoperative SSI. The median time to the development of SSI was 7 days (5–10). Of all infections, 67.5 % were superficial, 22.9 % were deep and 9.6 % were organ space. In univariate analysis, an ASA grade of II (RR 0.6, CI 0.3–0.9, P = 0.019), having an elective procedure (RR 0.4, CI 0.2–0.6, P < 0.001), using a laparoscopic approach (RR 0.5, CI 0.3–0.9, P = 0.019), having a daytime procedure (RR 0.3, CI 0.1–0.7, P = 0.006) and having a clean/contaminated wound (RR 0.4, CI 0.2–0.7, P = 0.001) were associated with reduced risk of SSI. In multivariate analysis, an ASA grade of IV (RR 3.9, CI 1.1–13.7, P = 0.034), a procedure duration over 3 h (RR 4.3, CI 2.3–8.2, P < 0.001) and undergoing a panproctocolectomy (RR 6.5, CI 1.0–40.9, P = 0.044) were independent risk factors for SSI. Those who developed an SSI had a longer duration of inpatient stay (22 days [16–31] vs 15 days [10–26], P < 0.001).

Conclusions

Patients who develop an SSI have a longer duration of inpatient stay. Independent risk factors for SSI following colorectal resection include being ASA grade IV, having a procedure duration over 3 h, and undergoing a panproctocolectomy.

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Authors and Affiliations

  1. Department of Surgery, Wexford General Hospital, Wexford, Ireland

    Derek B. Hennessey & Kenneth Mealy

  2. St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland

    Derek B. Hennessey, John P. Burke & Desmond C. Winter

  3. Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland

    Tara Ni-Dhonochu & Conor Shields

Authors
  1. Derek B. Hennessey
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  2. John P. Burke
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  3. Tara Ni-Dhonochu
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  4. Conor Shields
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  5. Desmond C. Winter
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  6. Kenneth Mealy
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Correspondence to Derek B. Hennessey.

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Hennessey, D.B., Burke, J.P., Ni-Dhonochu, T. et al. Risk factors for surgical site infection following colorectal resection: a multi-institutional study. Int J Colorectal Dis 31, 267–271 (2016). https://doi.org/10.1007/s00384-015-2413-5

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  • DOI: https://doi.org/10.1007/s00384-015-2413-5

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