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Revista Salud Uninorte
Print version ISSN 0120-5552On-line version ISSN 2011-7531
Abstract
PENUELA-EPALZA, Martha Elena et al. Risk factors for surgical-site infection in the atlantic state, colombia. A case-control study. Salud, Barranquilla [online]. 2018, vol.34, n.1, pp.97-108. ISSN 0120-5552.
Objective:
To evaluate sociodemographic, clinical and health-service-related determinants associated to surgical site infections in patients undergoing appendectomy in third level Hospitals, located in the Colombian Northern Region, from 2009 to 2013.
Methods:
Retrospective data was collected of hospital records from participating hospitals; 80 cases and 272 controls were compared regarding socio-demographic (age, gender, regime of affiliation to the social-security health system), clinical (comorbidity, prior hospitalization, degree of appendix), and healthcare-related variables (diagnostic time, preoperative time, operation duration, prophylaxis with antibiotics and hospital-stay length). Both bivariate and multivariate analysis were conducted. Odds Ratios, 95% confidence intervals were estimated; Besides, both X2-Test and T Student Tests were used to evaluate statistical significance.
Results:
Socio-demographic (age, affiliation to the subsidized-health-system), clinical (metabolic disease) and health-care related factors such as preoperative waiting time showed to be associated to surgical site infections, in the bivariate analysis. In the final regression model only age above 54 (OR= 5,37); subsidized affiliation to the social security system (3,49) and histopathological grade of appendix, which included focal inflammation, epithelial ulcers, and isolated micro-abscesses in lymphatic’s follicles showed to be independent risk factors (OR= 1,98).
Conclusion:
This study adds new evidence on the multifactorial origin of post-surgery nosocomial infections and spotlights health inequality as a major risk factor that needs to be addressed.
Keywords : Appendectomy; surgical wound infection; Clinical Factors; Case-Control; health inequality; subsidized health system; nosocomial infections; Colombia..