Risk factors for surgical site infection following colorectal resection: a multi-institutional study.
BACKGROUND
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.
Department of Surgery, Wexford General Hospital, Wexford, Ireland. derek.hennessey@gmail.com.|St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. derek.hennessey@gmail.com.
Derek B
DB
Hennessey
St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
John P
JP
Burke
Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
Tara
T
Ni-Dhonochu
Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
Conor
C
Shields
St Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
Desmond C
DC
Winter
Department of Surgery, Wexford General Hospital, Wexford, Ireland.
Kenneth
K
Mealy
D000368:Aged; D003082:Colectomy / Q000009:adverse effects; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*
Colorectal surgery; Risk; Surgical site infection; Wound infection