Time of developing surgical site infections and its association with patient and procedure characteristics

Abstract

Background

Understanding the timeframe and risk of developing surgical site infection (SSI) is essential for effective prevention and management strategies. The objective was to examine the post-operative duration before developing SSI and to characterize their patient and procedure characteristics.

Methods

Prospective SSI surveillance was conducted on 15 operative procedures between 2014 and 2023 in a tertiary-care hospital system. The duration before developing SSI was divided into two groups; early-onset (<median) and late-onset (≥ median) SSIs.

Results

A total 322 SSI events were included. Approximately 76.7 % of them were superficial, 13.0 % deep, and 10.2 % organ. The majority were detected after discharge (66.6 %) and were laboratory-confirmed (64.6 %). The majority of procedures with SSI were inpatient procedures (96.9 %) and had risk index category of one (70.2 %). The median and mode (most frequent) duration before developing SSI were 15 and 10 days, respectively. Approximately 92.5 % and 98.8 % of SSI were detected within first 30 or 60 days, respectively. After adjusting for all variables that were associated with the duration before developing SSI in univariate analysis, early-onset SSI was significantly associated with female gender (odds ratio [OR] = 2.29, 95 % confidence 1.18–4.45, p = 0.015) and detection before hospital discharge (OR = 8.06, 95 % confidence 3.83–16.93, p < 0.001) but not coronary artery bypass graft (OR = 0.27, 95 % confidence 0.15–0.51, p < 0.001).

Conclusions

As most of SSI are detected after discharge, the findings underscore the importance of post-discharge surveillance that can be considered as a quality indicator for surveillance. Reducing the SSI follow-up durations from 90 days to 60 days, wouldn’t make much difference.