MAGNITUDE OF SURGICAL SITE INFECTIONS AND ASSOCIATED FACTORS AMONG PATIENTS WHO HAD EMERGENCY ABDOMINAL OPERATION

Abstract

Background: Surgical site infections are the most common nosocomial infection and frequently cause morbidity and mortality among inpatients of hospitals. The incidence varies from hospital to hospital. Several factors affect the development of surgical site infections. Even though the extent of surgical site infection in Ethiopia is high, there are no published studies on emergency abdominal surgical site infection and there is no baseline information regarding SSI in Chiro General Hospital, Eastern Ethiopia. Objectives: The objective of this study was to assess the magnitude of abdominal surgical site infections and associated factors among emergency abdominally operated patients in Chiro General Hospital, Chiro Town, Eastern Ethiopia, Materials and Methods: Study Period: A Hospital based cross sectional patient Card review study was conducted among all emergency abdominal operated cases (652) in three years. The sample size was computed for single population proportion prevalence of surgical site infection and the sample size was estimated to be 538. Adding 10% contingency a total 592 was the total sample size required for this study. A predesigned and pretested check list was used to collect the data. The data was collected by 3 nurses trained for the data collection using a checklist prepared for the data collection. Data was analyzed using SPSS 20.0 software for descriptive statistics and regression. Results: Among the total of 539 emergency abdominally operated clients the total prevalence of surgical site infection was 158(29.3%) and with 95% confidence the true estimate lies 22.2% to 36.39%. On multivariable analysis Age of the patient greater than 50 years are significant contributors for development of Surgical Site Infection. Cases with preoperative diagnosis of Perforated PUD, AOR=1.637, (95%, CI: [1.112-3.811]) , Peritonitis, AOR=1.388,(95%, CI: [1.057-2.663]) , Non-provision of prophylactic antibiotics preoperatively AOR=131.133, (95%, CI:[ 47.484- 162.143])and dirty wound contamination class during the procedure, AOR=53.342, (95%, CI: [2.422- 61.175]). were significantly associated with surgical site infection. Conclusion: The prevalence of SSI was high. Old age, serious emergency cases such as perforated PUD, Peritonitis, not providing prophylactic antibiotics and dirty wound class during the procedure, were the important factors for development of surgical site infection. Clinicians and other emergency department and surgical ward staffs should provide preoperative prophylactic antibiotics consistently. Head of surgical ward and staff members should have strengthened timely surveillance and supervision mechanism of health facility on surgical site infection