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Peer-reviewedCC BY-NC-NDInternational wound journal

Surgical Site Infection: Conditional Influence of Surgery Duration and ASA Classification in Major Procedures.

  • Adriana Cristina Oliveira1
  • Robert Aldo Iquiapaza2
  1. 1School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
  2. 2Faculty of Economic Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Abstract

Surgical site infection (SSI) is a major complication in surgical patients. This study aimed to investigate predictors of SSI in cardiac, neurological and orthopaedic surgeries. A total of 28,803 procedures (2015-2021) were analysed. Predictive variables included age, sex, ASA score, wound classification, operative duration and preoperative stay. Logistic regression was applied. Overall SSI rate was 7.2% (2062 cases): 47% neurological, 39% cardiac and 15% orthopaedic. Infected patients had longer preoperative stays (median 6 [IQR: 2-13] vs. 3 days [IQR: 1-9], p < 0.001), extended operative times (median difference: 70 min, 95% CI: 60-79, p < 0.001), and prolonged hospitalizations (median difference: 14 days, 95% CI: 14-15, p < 0.001). Mortality was higher among infected patients (15% vs. 8.2%). Despite lower SSI incidence, orthopaedic patients had a 3.0-fold increase in median stay and 5.3-fold increased odds of death. A significant duration × ASA (> 3) interaction indicated that SSI risk increased with surgical time in high-severity patients. Model adequacy was confirmed by the Hosmer-Lemeshow test (p = 0.481). Higher ASA scores, prolonged surgeries, and extended preoperative stays are significant contributors to SSI risk in major procedures.

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Cite

BibTeXRIS
BibTeX
@article{oliveira2026surgical,
  title = {{Surgical Site Infection: Conditional Influence of Surgery Duration and ASA Classification in Major Procedures.}},
  author = {Adriana Cristina Oliveira and Robert Aldo Iquiapaza},
  journal = {International wound journal},
  year = {2026},
  month = nov,
  doi = {10.1111/iwj.71088},
  url = {https://europepmc.org/article/MED/42972845},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Surgical Site Infection: Conditional Influence of Surgery Duration and ASA Classification in Major Procedures.
AU  - Adriana Cristina Oliveira
AU  - Robert Aldo Iquiapaza
PY  - 2026
DA  - 2026/11/01
JO  - International wound journal
DO  - 10.1111/iwj.71088
UR  - https://europepmc.org/article/MED/42972845
AB  - Surgical site infection (SSI) is a major complication in surgical patients. This study aimed to investigate predictors of SSI in cardiac, neurological and orthopaedic surgeries. A total of 28,803 procedures (2015-2021) were analysed. Predictive variables included age, sex, ASA score, wound classification, operative duration and preoperative stay. Logistic regression was applied. Overall SSI rate was 7.2% (2062 cases): 47% neurological, 39% cardiac and 15% orthopaedic. Infected patients had longer preoperative stays (median 6 [IQR: 2-13] vs. 3 days [IQR: 1-9], p < 0.001), extended operative times (median difference: 70 min, 95% CI: 60-79, p < 0.001), and prolonged hospitalizations (median difference: 14 days, 95% CI: 14-15, p < 0.001). Mortality was higher among infected patients (15% vs. 8.2%). Despite lower SSI incidence, orthopaedic patients had a 3.0-fold increase in median stay and 5.3-fold increased odds of death. A significant duration × ASA (> 3) interaction indicated that SSI risk increased with surgical time in high-severity patients. Model adequacy was confirmed by the Hosmer-Lemeshow test (p = 0.481). Higher ASA scores, prolonged surgeries, and extended preoperative stays are significant contributors to SSI risk in major procedures.
SN  - 1742-4801
SN  - 1742-481X
ER  -