title: Risk factors for surgical site infections in abdominal surgery: a study in Nepal.
abstract: BACKGROUND
  Surgical site infection (SSI) remains a major clinical problem for developing countries in terms of morbidity, mortality, and hospital cost. Little is known about the epidemiology of SSI in Nepal. We conducted a study in Nepal to identify the various pre- and intra-operative risk factors for SSIs that are accessible to interventions.
  
  
  METHODS
  The study was a prospective study done on all eligible patients who underwent abdominal surgery in the surgical wards of Tribhuvan University Teaching Hospital (TUTH) in Kathmandu, Nepal, from January 2011 to June 2011. We evaluated some patient-related as well as intra-operative variables that could be risk factors for SSIs. We assessed the association between these risk factors and SSI with the Fisher exact test and logistic regression analysis.
  
  
  RESULTS
  Of the 230 patients included in the study, 53 were identified as having a SSI, resulting in an overall rate of SSI of 23%. Multivariable analysis identified the following factors as independent risk factors for SSI: (1) Low hemoglobin concentrations (<12 g/dL) (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.1-6.1); (2) overweight (OR 7.6; 95% CI 2.1-27.0); and (3) surgery performed by residents (OR 3.4; 95% CI 1.4-8.3).
  
  
  CONCLUSIONS
  Surgical site infection is common among patients undergoing abdominal surgery at TUTH. This study identified some preventable risk factors associated with SSI at TUTH. Identification of such risk factors is expected to help surgeons improve patient care and decrease mortality and morbidity as well as the hospital-care cost of surgical patients.
authors.affiliation: Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. smithgiri963@gmail.com
authors.forename: Smith
authors.initials: S
authors.lastname: Giri
authors.forename: Bishnu P
authors.initials: BP
authors.lastname: Kandel
authors.forename: Sushil
authors.initials: S
authors.lastname: Pant
authors.forename: Paleswan Joshi
authors.initials: PJ
authors.lastname: Lakhey
authors.forename: Yogendra P
authors.initials: YP
authors.lastname: Singh
authors.forename: Pradeep
authors.initials: P
authors.lastname: Vaidya
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009390:Nepal; D016017:Odds Ratio; D011182:Postoperative Care; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents