title: Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center.
abstract: We aimed to determine the incidence of surgical site infection (SSI) after cesarean delivery (CD) and identify the risk factors in a rural population.
  
  
  
  We identified 218 SSI patients by International Classification of Disease codes and matched them with 3131 parturients (control) from the electronic record database in a time-matched retrospective quality assurance analysis.
  
  
  
  The incidence of SSI after CD was 7.0 %. Risk factors included higher body mass index (BMI) [40.30 ± 10.60 kg/m2SSI (95 % CI 38.73-41.87) vs 34.05 ± 8.24 kg/m2control (95 % CI 33.75-34.35, P < 0.001)], years of education [13.28 ± 2.44 years SSI (95 % CI 12.9-13.66) vs 14.07 ± 2.81 years control (95 % CI 13.96-14.18, P < 0.001)], number of prior births [2 (1-9) SSI vs 1 (1-11) control (P < 0.001)], tobacco use (OR 1.49; 95 % CI 1.06-2.09, P = 0.03), prior diagnosis of hypertension (OR 1.80; 95 % CI 1.34-2.42, P < 0.001), gestational diabetes (OR 1.59; 95 % CI 1.18-2.13, P = 0.003), and an emergency/STAT CD (OR 1.6; 95 % CI 1.1-2.3, P = 0.01).
  
  
  
  Risk factors for SSI after CD included higher BMI, less years of education, higher prior births, tobacco use, prior diagnosis of hypertension, gestational diabetes, and emergency/STAT CD. The presence of ruptured membranes was protective against SSI.
authors.affiliation: Department of Medical Education, Robert C. Byrd Health Sciences Center, School of Medicine, West Virginia University, PO Box 9001A, Morgantown, WV, 26506, USA. mcvallejo@hsc.wvu.edu.|Department of Anesthesiology, School of Medicine, West Virginia University, 1 Medical Center Dr., PO Box 8255, Morgantown, WV, 26506, USA. mcvallejo@hsc.wvu.edu.
authors.forename: Manuel C
authors.initials: MC
authors.lastname: Vallejo
authors.affiliation: Department of Anesthesiology, School of Medicine, West Virginia University, 1 Medical Center Dr., PO Box 8255, Morgantown, WV, 26506, USA.
authors.forename: Ahmed F
authors.initials: AF
authors.lastname: Attaallah
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, West Virginia University, 1 Medical Center Dr., PO Box 9186, Morgantown, WV, 26506, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Shapiro
authors.affiliation: Department of Anesthesiology, School of Medicine, West Virginia University, 1 Medical Center Dr., PO Box 8255, Morgantown, WV, 26506, USA.
authors.forename: Osama M
authors.initials: OM
authors.lastname: Elzamzamy
authors.affiliation: Department of Health Policy, Management, and Leadership, School of Public Health, West Virginia University, 1 Medical Center Dr., PO Box 9190, Morgantown, WV, 26506, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Mueller
authors.affiliation: Department of Health Policy, Management, and Leadership, School of Public Health, West Virginia University, 1 Medical Center Dr., PO Box 9190, Morgantown, WV, 26506, USA.
authors.forename: Warren S
authors.initials: WS
authors.lastname: Eller
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Cesarean delivery; Electronic medical record; Risk factors; Surgical site infection