[Risk factors for surgical site infection after colorectal cancer surgery: a two-center retrospective study].

Objective: To analyze the incidence of surgical site infection (SSI) in patients undergoing colorectal cancer (CRC) surgery and to identify risk factors associated with SSI in an attempt to provide a reference for clinical prevention strategies. Methods: A retrospective cohort study was conducted. Clinical data were retrospectively collected from a total of 2,248 patients who underwent surgery for pathologically confirmed CRC between 2017 and 2022 at two centers: Huangshan Shoukang Hospital (n=649) and Northern Jiangsu People's Hospital (n=1 599). Inclusion criteria consisted of the following: (1) age >18 years; (2) pathologically confirmed CRC treated with curative resection, including extended resections (e.g. pelvic exenteration); (3) no surgical incisions other than abdominal or perineal; and (4) no use of prosthetic implants. The incidence of SSI was analyzed, and multivariate logistic regression was used to identify independent its risk factors. Results: A total of 121 patients (5.4%) developed SSI. Among them, 68 cases (56.2%) were organ/space infections, 35 cases (28.9%) were deep incisional infections, and 18 cases (14.9%) were superficial incisional infections. The median postoperative hospital stay was significantly longer in patients with SSI compared to those without (21.0 days vs. 13.0 days, U=65,754, P<0.001). The median hospitalization cost was also significantly higher in the SSI group (56,550 yuan vs. 43,645 yuan, U=72,008, P<0.001). Multivariate logistic regression analysis identified body mass index (BMI) ≤ 20 kg/m2 (OR=4.25, 95%CI: 3.38-5.34, P<0.001), diabetes mellitus (OR=3.44, 95%CI: 1.89-6.24, P<0.001), open surgery (OR=4.23, 95%CI: 2.37-7.56, P<0.001), and colostomy or ileostomy (OR=1.67, 95% CI: 1.04-2.69, P=0.034) as independent risk factors for SSI. Conclusion: To prevent SSI following CRC surgery, attention should be given to optimizing body weight and glycemic control, promoting minimally invasive surgical approaches when feasible, and cautiously considering the necessity of colostomy or ileostomy.