Abstract

RISK FACTORS FOR SSIs IN PATIENTS UNDERGOING GASTROINTESTINAL SURGERY AT A TERTIARY CARE HOSPITAL IN SOUTH INDIA

*R.Ashok¹, V.Lakshmi¹,K.Anuradha¹, Ananda Kumar², N.Bheerappa², R.A.Sastry²

ABSTRACT

Introduction: Surgical site infections (SSIs) are the most common nosocomial infections in surgical patients, accounting for 38% of all such infections. SSIs influence the final outcome of the operation such as delay in discharge, loss of income and increased hospital cost. Several studies have reported that certain factors related to the patient and the surgical procedure(s) were associated with an increased risk of SSI. These included age, gender, obesity, habits like smoking, alcoholism, underlying chronic illnesses like diabetes mellitus, malignancy, renal failure and serum albumin less than 3 mg/dl, preoperative stay for more than 3 days, previous interventions, ongoing immunosuppressive therapy such as steroid use (for chronic medical condition). Multiple combinations of these factors were responsible for reducing the host immunity and thereby increased the risk for SSIs in a given patient. However, none of these factors individually were associated with increased rates of SSIs. They were always complementary to the type of surgery performed. In this study we attempted to reevaluate the risk factors for SSI in a large cohort of patients undergoing gastrointestinal surgery at our hospital. Methods: This prospective study included 1007 patients who had undergone gastrointestinal surgery. Data were collected through preoperative, intraoperative, postoperative examination and post discharge follow-up in the out-patient department. The relationships among the risk variables were analyzed by using Epi Info software. Results: The overall surgical site infection rate was 11.3% (114/1007). The wound infection rate was 1.8% in patients with clean surgery, 6.26% in clean contaminated surgeries, 30.9% in contaminated surgeries and 34.4% in dirty surgeries. Conclusions: The present study indicated that the type of wound, emergency surgery, presence of diabetes mellitus, previous interventions at the same site and duration of surgery for more than T hours were significant predictors for SSIs in gastrointestinal surgery.

Keywords: SSI, RISK FACTORS, GASTROINTESTINAL SURGERY.