Background: Patients with colorectal cancer suffer from impaired nutritional status, which has been a proven contributing factor of postoperative morbidity and mortality, especially surgical site infection (SSI). The current study was conducted to identify the risk factors for the development of surgical site infection in patients with colorectal cancer.
Methods: A prospective cohort study of 60 patients, who underwent colectomy for colorectal cancer, was performed in three tertiary care hospitals in Palestine starting from September 2017 until March 2019. Demographic and clinical information, as well as blood samples, were collected from patients before undergoing surgery. Patients were followed up for 30 days to assess for the development of surgical site infection. Risk factors for postoperative SSI were analyzed.
Results: The overall surgical site infection rate was 31.7 %. Factors associated with surgical site infection by univariate analysis were age > 60 (P < 0.001), lower educational level (P < 0.001), marital status, (P < 0.001), unemployment (P < 0.011), diabetes mellitus (P< 0.01), advanced stage of cancer (P< 0.004), lower concentration of albumin (P< 0.001) and lower concentration of prealbumin (P< 0.0001). The multivariate analysis using a binary logistic model showed that none of these variables was significant in the development of SSI.
Conclusions: The factors that were associated with surgical site infection among patients with colorectal cancer after surgery were lower educational level, marital status, unemployment, diabetes mellitus, advanced stages of cancer, and poor nutritional status as indicated by lower concentration of albumin and prealbumin. Interventions to improve nutritional status in these patients should focus more on patients with advanced stages of cancer and diabetes mellitus