Table 4.
Patient-dependent, disease-dependent, and treatment-dependent factors associated with significantly lower/higher risk of surgical site infections (SSIs) for particular types of SSIs
| Factors | All types of SSIs Ad. OR (95 % CI) |
Skin superficial SSIs Ad. OR (95 % CI) |
Deep incisional SSI Ad. OR (95 % CI) |
Organ-space SSIs Ad. OR (95 % CI) |
|---|---|---|---|---|
| Hospital | ||||
| Center 1 | ||||
| Center 2 | ||||
| Patient-dependent | ||||
| Age | ||||
| <65 | ref. | ref. | ||
| >65 | 0.68 (0.62–0.74) | 0.84 (0.80–0.90) | ||
| BMI | ||||
| <20.0 | 1.46 (1.38–1.49) | |||
| 20.01–25.0 | ref. | ref. | ref. | ref. |
| 25.01–30.0 | ||||
| >30.01 | 1.58 (1.49–1.64) | 1.53 (1.47–1.59) | 1.42 (1.39–1.45) | 1.68 (1.64–1.73) |
| Albumin | ||||
| ≥35 mg/ml | ref. | ref. | ||
| <35 mg/ml | 1.61 (1.58–1.64) | 1.12 (1.10–1.15) | ||
| Respiratory disease | ||||
| No | ref. | |||
| Yes | 1.29 (1.24–1.33) | |||
| ASA Score | ||||
| I | ref. | ref. | ref. | ref. |
| II | ||||
| III | 1.12 (1.10–1.14) | |||
| IV | 1.82 (1.78–1.83) | 1.98 (1.93–2.01) | 1.79 (1.75–1.83) | 1.80 (1.78–1.83) |
| Disease-dependent | ||||
| Location of the tumor | ||||
| Colon | ref. | ref. | ||
| Rectum | 1.28 (1.22–1.34) | 1.13 (1.09–1.15) | ||
| Location of the tumor | ||||
| Right colon | ref. | ref. | ref. | ref. |
| Left colon | ||||
| Upper rectum | 0.91 (0.88–0.93) | 0.93 (0.90–0.98) | ||
| Middle rectum | ||||
| Lower rectum | 1.26 (1.22–1.30) | 1.34 (1.31–1.36) | 1.18 (1.13–1.24) | 1.21 (1.18–1.23) |
| Mode of operation | ||||
| Elective | ref. | ref. | ref. | ref. |
| Emergency | 1.34 (1.30–1.39) | 1.46 (1.43–1.50) | 1.29 (1.23–1.28) | 1.32 (1.28–1.34) |
| Pathology (AJCC) | ||||
| I | ref. | ref. | ref. | |
| II | ||||
| III | ||||
| IV | 1.33 (1.31–1.35) | 1.36 (1.33–1.39) | 1.29 (1.27–1.32) | |
| Treatment-dependent | ||||
| Type of bowel preparation | ||||
| MBP−/ABX− | ref. | ref. | ref. | ref. |
| MBP+/ABX+ | 0.53 (0.44–0.59) | |||
| Resection procedure | ||||
| Right colectomy | 0.68 (0.65–0.69) | 0.79 (0.77–0.81) | ||
| Left colectomy | ||||
| Sigmoidectomy | ||||
| Hartmann’s | ref. | ref. | ref. | ref. |
| AR | 1.12 (1.09–1.14) | |||
| LAR | 1.51 (1.47–1.54) | 1.62 (1.60–1.64) | ||
| APR | 1.69 (1.63–1.75) | 1.75 (1.70–1.79) | 1.49 (1.43–1.52) | |
| Anastomosis | ||||
| No | ref. | ref. | ref. | |
| Yes | 1.77 (1.73–1.82) | 1.73 (1.71–1.75) | 1.87 (1.83–1.90) | |
| Type of operation | ||||
| Palliative | ref. | ref. | ||
| Radical | 1.39 (1.33–1.43) | 1.42 (1.40–1.45) | ||
| Operation time | ||||
| <180 min | ref. | ref. | ref. | |
| ≥180 min | 1.64 (1.60–1.71) | 1.68 (1.61–1.77) | 1.56 (1.48–1.61) | |
| Neoadjuvant therapya | ||||
| None | ref. | ref. | ref. | ref. |
| Radiotherapy | 1.72 (1.68–1.77) | 1.39 (1.33–1.45) | 1.67 (1.65–1.70) | 1.78 (1.75–1.80) |
| Radiochemotherapy | 1.64 (1.60–1.69) | 1.71 (1.69–1.72) | 1.62 (1.60–1.61) | |
| Protective stomaa | ||||
| Yes | ref. | ref. | ||
| No | 1.16 (1.13–1.20) | 1.13 (1.11–1.16) | ||
Only significant values of adjusted odds ratio (Ad. OR) were presented (p < 0.05)
Center 1 Department of General and Colorectal Surgery, center 2 Center for Treatment of Bowel Diseases, MBP mechanical bowel preparation, ABX oral antibiotic prophylaxis, SSIs surgical site infections, BMI body mass index, ASA American Society of Anesthesiologist, AJCC American Joint Committee for Cancer, AR anterior resection, LAR low anterior resection with the level of anastomosis <6 cm), APR abdominal perineal resection, Ad. OR adjusted odds ratio, ref. reference
aData refers only to rectal cancer