Risk Factors for Surgical Site Infections After Appendectomy for Acute Appendicitis

Abstract

Background: Surgical site infections are the most common hospital-acquired infections that increase overall cost and length of hospital stay, and are largely preventable. In the meantime, appendectomy remains a common surgical procedure related to a considerable risk of surgical site infections (SSIs). We aim to identify risk factors for SSI in patients who had undergone appendectomy in our setting. Subjects and Methods: A total of 292 patients who underwent open appendectomy between   July 2017 to June 2021 in People’s Dental College and Hospital, Kathmandu, Nepal were included.  We divided patients into two groups based on the occurrence of SSI postoperatively; the SSI group and the non-SSI group. Patient demographic characteristics and perioperative data were compared between two groups. Results: Out of total 292 patients who underwent open appendectomy, 39 (13.4%) patients developed SSI.  Mean ages were 31.8 ±8.08 years. In logistic regression analysis, on multivariate analysis, out of independent variables sex (male), presence of comorbidity, WCC (≥ 16000 /mm3)), CRP (≥ 65), type of appendicitis (complex), and duration of surgery (>60 mins), only WCC (≥ 16000/mm3)), and type of appendicitis (complex) were associated with an increased risk of SSI (P <0.005). Conclusion: White cell counts (≥ 16000/mm3)), and type of appendicitis (complex) were associated with an increased risk of SSI. Early diagnosis and prompt treatment are essential to decrease morbidity and financial burden due to surgical site infection.