Risk prediction in surgical site infection in patients submitted to the digestive surgery

Abstract

The aim of this study was to develop an alternate model to predict surgical wound infection in patients submitted to digestive tract surgery, to compare its predictive ability to that of the National Nosocomial Infection Surveillance System risk index, and to determine the incidence of surgical infection, in hospital and after discharge. It was a prospective cohort study, considering all patients submitted to digestive tract surgery at two teaching hospitals in São Paulo, from August 2001 to March 2002. The sample of the study included 609 patients all of whom were observed in hospital and after discharge. The overall incidence of surgical wound infection was 149 (24.5%); 33 (22.1%) of which were notified in hospital and 116 (77.9%) after discharge. Multivariate logistic regression analysis was used for construction of the model, using all variables whose p value was less than 0.20. The alternative model included: presence of obesity, contamination risk, adjusted duration and surgery risk; these variables significantly increased the risk for surgical wound infection. These results contribute to a critical and reflexive analysis by hospital infection control professionals about the epidemiological surveillance system adopted, favoring the recognition of risk factors in surgical patients and allowing for the proposal of control and preventive actions.