• Xufei Zhang, Yiyu Yang, Peizhao Liu, Peige Wang, Xuemin Li, Jianwei Zhu, Wei Mai, Weidong Jin, Wenjing Liu, Zhitao Zhou, Jiajie Wang, Meilin Wu, Rui Ma, Jiayu Chi, Xiuwen Wu, and Jianan Ren.
• Research Institute of General Surgery, Jinling Hospital, School of Medicine, Southeast University, Nanjing, China.
• Ann. Surg. 2023 Nov 1; 278 (5): e988e994e988-e994.

ObjectivesWe aimed to determine the current incidence rate and risk factors for surgical site infection (SSI) after abdominal surgery in China and to further demonstrate the clinical features of patients with SSI.BackgroundContemporary epidemiology and clinical features of SSI after abdominal surgery remain poorly characterized.MethodsA prospective multicenter cohort study was conducted from March 2021 to February 2022; the study included patients who underwent abdominal surgery at 42 hospitals in China. Multivariable logistic regression analysis was performed to identify risk factors for SSI. Latent class analysis (LCA) was used to explore the population characteristics of SSI.ResultsIn total, 23,982 patients were included in the study, of whom 1.8% developed SSI. There was a higher SSI incidence in open surgery (5.0%) than in laparoscopic or robotic surgeries (0.9%). Multivariable logistic regression indicated that the independent risk factors for SSI after abdominal surgery were older age, chronic liver disease, mechanical bowel preparation, oral antibiotic bowel preparation, colon or pancreas surgery, contaminated or dirty wounds, open surgery, and colostomy/ileostomy. LCA revealed 4 subphenotypes in patients undergoing abdominal surgery. Types α and β were mild subclasses with a lower SSI incidence; whereas types γ and δ were the critical subgroups with a higher SSI incidence, but their clinical features were different.ConclusionsLCA identified 4 subphenotypes in patients who underwent abdominal surgery. Types γ and δ were critical subgroups with a higher SSI incidence. This phenotype classification can be used to predict SSI after abdominal surgery.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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