Risk Factors for Surgical Site Infection After Appendectomy for Acute Appendicitis; Results of a Cross-Sectional Study Carried out at a Community Hospital in Qatar (2013-2016)

Abstract

Background: Identifying risk factors for surgical site infection (SSI) after appendectomies could be useful in focusing prevention programs. Objective: The current study aimed to identify the risk factors associated with SSI in a cohort of patients from a single center in Western Qatar. Methods: This cross-sectional study was carried out at The Cuban Hospital (Dukhan, Qatar) on patients who had undergone an appendectomy from January 2013 through September 2016. Data extracted from the patient files included demographics, comorbidities and toxic habits, surgery type, procedure duration, wound type, appendicitis-type, American Anesthesiology Score, body mass index, selected laboratory tests, and compliance with antibiotic prophylaxis. Results: The study variables, type of surgery performed, procedure duration, wound and appendicitis type, serum albumin, and timing of antibiotic prophylaxis, were found to be related to the occurrence of SSI in univariate analysis (P = 0.000). Logistic regression showed that open appendectomies (odds ratio [OR] = 22.90, 95% CI; 8.04-65.21), low serum albumin (OR = 0.92, 95% CI; 0.85-0.99), and improper timing of antibiotic prophylaxis (OR = 44.92, 95% CI; 3.39-594.91) were independently associated with the occurrence of SSI. Conclusion: Cases of complex appendicitis, open procedure, low serum albumin level, and improper timing of antibiotic prophylaxis constituted the risk factors for SSI in the setting of this study. The infection control program should focus on improving the quality of antibiotic prophylaxis and closely monitoring patients who undergo open surgical procedures.