Risk Factors for Surgical Site Infections in Elective and Emergency Surgeries: A Prospective Cohort Study.

Abstract

Background: Surgical site infections (SSIs) cause morbidity, disabilities, and healthcare costs. This study aims to assess patient- and surgery-related factors influencing SSIs with standardized preoperative, operative, and postoperative care.

Methods: This prospective cohort study involved 140 patients undergoing elective or emergency surgeries at Al-Azhar University Hospitals, Egypt, from October 2020 to September 2021. Patients were stratified into two groups: emergency (Group A) and elective (Group B). Risk factors for SSIs were assessed through observational and analytical methods, focusing on adults aged 15 and older without prior infections. The chi-square test was utilized to assess the strength of associations for categorical variables. Statistical significance was determined at a p-value under 0.05, with a 95% confidence interval employed for all analyses. Data were tabulated using a spreadsheet and analyzed with IBM SPSS Statistics for Windows, Version 20.

Results: Among 140 patients, 25 developed SSIs (19 men, 6 women). Significant differences were found in wound type (P = 0.001, surgery type (P = 0.002), and operative time (P = 0.010). SSI risk was higher for dirty (45.8%), contaminated (31.3%), and clean-contaminated (12.9%) wounds. Prolonged operative times (≥60 minutes) increased SSI risk (57.9% vs. 40.6%, P = 0.010). Diabetic patients had a higher incidence. In emergency surgeries, E. coli, Staphylococcus aureus, and Pseudomonas aeruginosa predominated, while S. aureus and Citrobacter were more common in elective surgeries. Amikacin, metronidazole, azithromycin, and imipenem were effective antibiotics.

Conclusion: SSIs were more common in emergency surgeries. Risk factors included smoking, diabetes, wound contamination, and prolonged operative times. Effective antibiotic use and infection control measures can decrease SSI occurrence.