title: Incidence of and risk factors for surgical site infections in women undergoing hysterectomy for endometrial carcinoma.
abstract: BACKGROUND
  The purpose of this study was to determine the incidence of, and risk factors for, surgical site infections in a contemporary cohort of women with endometrial carcinoma.
  
  
  METHODS
  We retrospectively studied 1164 women treated for endometrial carcinoma by hysterectomy at a single institution in 2007-2013. In all, 912 women (78.4%) had minimally invasive hysterectomy. Data on surgical site infections were collected from medical records. Univariate and multivariate analyses were used to identify risk factors for incisional and organ/space infections.
  
  
  RESULTS
  Ninety-four women (8.1%) were diagnosed with a surgical site infection. Twenty women (1.7%) had an incisional infection and 74 (6.4%) had an organ/space infection. The associations of 17 clinico-pathologic and surgical variables were tested by univariate analyses. Those variables that were identified as potential risk factors in univariate analyses (p < 0.15) were used in logistic regression models with incisional and organ/space infections as dependent variables. Obesity (body mass index ≥ 30 kg/m(2)), diabetes, and long operative time (>80th centile) were independently associated with a higher risk of incisional infection, whereas minimally invasive surgery was associated with a smaller risk. Smoking, conversion to laparotomy, and lymphadenectomy were associated with a higher risk of organ/space infection.
  
  
  CONCLUSIONS
  Organ/space infections comprised the majority of surgical site infections. Risk factors for incisional and organ/space infections differed. Minimally invasive hysterectomy was associated with a smaller risk of incisional infections but not of organ/space infections.
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Taru
authors.identifier: http://orcid.org/0000-0002-8900-1370
authors.initials: T
authors.lastname: Tuomi
authors.affiliation: Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Annukka
authors.identifier: http://orcid.org/0000-0002-0079-9807
authors.initials: A
authors.lastname: Pasanen
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Arto
authors.identifier: http://orcid.org/0000-0001-8360-3277
authors.initials: A
authors.lastname: Leminen
authors.affiliation: Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Ralf
authors.identifier: http://orcid.org/0000-0003-4366-5099
authors.initials: R
authors.lastname: Bützow
authors.affiliation: Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Mikko
authors.identifier: http://orcid.org/0000-0002-4372-2367
authors.initials: M
authors.lastname: Loukovaara
mesh_terms: D000368:Aged; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*
keywords: Endometrial carcinoma; hysterectomy; minimally invasive surgery; surgical site infection