Rayzah Musaed
Department of Surgery, College of Medicine, Majmaah University, P.O. Box 66, Al-Majmaah 11952, Riyadh, Saudi Arabia.
Healthcare (Basel). 2025 Jul 25;13(15):1808. doi: 10.3390/healthcare13151808.
Deep surgical site infections (SSIs) represent a serious complication following abdominal trauma surgery; however, comprehensive risk factor analysis in large trauma populations remains limited. Although surgical site infections are recognized as preventable complications, little is known about the specific risk factors and clinical outcomes associated with deep SSIs in trauma patients at the national level. A retrospective cohort study analyzed data from the National Trauma Data Bank from 2020-2022, including 1,198,262 trauma patients with complete demographic, injury severity, and surgical procedure data. Deep SSI development, length of hospital stay, intensive care unit utilization, duration of mechanical ventilation, discharge disposition, and in-hospital mortality were assessed. Multivariate logistic regression was used to identify independent risk factors and quantify associations between patient characteristics and deep SSI occurrence. Deep SSIs occurred in 601 patients (0.05%). Affected patients were younger (median 41 vs. 54 years, < 0.001), predominantly male (73.7% vs. 61.8%, < 0.001), and exhibited higher injury severity scores (median 17.0 vs. 5.0, < 0.001). Major abdominal surgery was the strongest independent predictor (OR 3.08, 95% CI: 2.21-4.23, < 0.001), followed by injury severity score (OR 1.05, 95% CI: 1.04-1.06, < 0.001) and ICU length of stay (OR 1.04 per day, 95% CI: 1.03-1.05, < 0.001). Patients with deep SSIs demonstrated dramatically increased hospital stays (89.5% vs. 4.5% exceeding 21 days, < 0.001), reduced home discharge rates (28.5% vs. 48.9%, < 0.001), and higher mortality (4.2% vs. 1.2%, < 0.001). Major abdominal surgery and injury severity are primary risk factors for deep SSIs in trauma patients, with profound impacts on clinical outcomes and healthcare resource utilization. These findings highlight the importance of targeted prevention strategies for high-risk trauma patients undergoing major abdominal procedures and emphasize the significant burden that deep SSIs place on healthcare systems.
深部手术部位感染（SSIs）是腹部创伤手术后的一种严重并发症；然而，在大型创伤人群中进行全面的危险因素分析仍然有限。尽管手术部位感染被认为是可预防的并发症，但在国家层面上，对于创伤患者深部SSIs的具体危险因素和临床结局知之甚少。一项回顾性队列研究分析了2020年至2022年国家创伤数据库的数据，包括1,198,262例具有完整人口统计学、损伤严重程度和手术程序数据的创伤患者。评估了深部SSIs的发生情况、住院时间、重症监护病房的使用情况、机械通气时间、出院处置情况和院内死亡率。采用多变量逻辑回归来确定独立危险因素，并量化患者特征与深部SSIs发生之间的关联。601例患者（0.05%）发生了深部SSIs。受影响的患者更年轻（中位年龄41岁对54岁，<0.001），男性为主（73.7%对61.8%，<0.001），并且损伤严重程度评分更高（中位值17.0对5.0，<0.001）。腹部大手术是最强的独立预测因素（OR 3.08，95%CI：2.21-4.23，<0.001），其次是损伤严重程度评分（OR 1.05，95%CI：1.04-1.06，<0.001）和ICU住院时间（每天OR 1.04，95%CI：1.03-1.05，<0.001）。发生深部SSIs的患者住院时间显著延长（超过21天的比例为89.5%对4.5%，<0.001），家庭出院率降低（28.5%对48.9%，<0.001），死亡率更高（4.2%对1.2%，<0.001）。腹部大手术和损伤严重程度是创伤患者深部SSIs的主要危险因素，对临床结局和医疗资源利用有深远影响。这些发现突出了针对接受腹部大手术的高危创伤患者采取针对性预防策略的重要性，并强调了深部SSIs给医疗系统带来的巨大负担。
