Factors Predicting Surgical Site Infection in Older Adults Undergoing Abdominal Surgery: A Retrospective Cohort Study

Abstract

Surgical site infection is a significant health problem among nosocomial infections, leading to post-operative mortality in surgical older adults. Identifying risk factors is essential in surgical care quality. This retrospective cohort study, conducted at a university hospital in Bangkok, rigorously examined the surgical site infection rate and its predictive factors in older adults undergoing abdominal surgery. The study employed convenience sampling to recruit 300 older adults who underwent abdominal surgery using the code of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and completion of electronic medical records between January 1 and December 31, 2020. The instruments used included the Demographic Characteristics Form, the Preoperative Clinical Characteristics Form, the Intraoperative Record Form, and the Post-operative Record Form. The data collected were analyzed using descriptive statistics and binary logistic regression analysis, ensuring a comprehensive and robust analysis of the risk factors for surgical site infection in older adults undergoing abdominal surgery. The results of this study revealed that 63.25% of participants were female, with a mean age of 74.5 years. The surgical site infection rate was 12 per 100 patients, varying across anatomical locations and surgical procedures, ranging from 0.33% to 5.66%, with colon surgery being the most common. The study identified significant risk factors predicting surgical site infection, including comorbidities and obesity class 2, while the American Society of Anesthesiologists Physical Status class 2 and 3 were identified as protective factors. These findings provide a powerful tool to screen patients at risk of surgical site infection in nursing practice, particularly with older adults undergoing colon surgery, and to prevent surgical site infection.