Thrombocytosis Is a Risk Factor for Surgical Site Infections after Colon Resection: A Prospective Observational Study

Colon operations have the highest rate of surgical site infections (SSI) among all general surgical procedures. The aim of this study was to identify the risk factors associated with the development of SSI after colon resection.

A prospective study was conducted including patients over 18 years of age who underwent colon resection at a tertiary center. Data concerning peri-operative parameters were collected. Uni-variable and multi-variable statistics were employed. For identifying the potential risk factors, we used odds ratio (OR) with 95% confidence interval (CI).

A total of 44 SSI were recorded from a total patient cohort of 300, yielding a rate of 14.7%. The SSIs were categorized into incisional (n = 37, 77.1%), deep (n = 4, 8.3%), and organ/space SSI (n = 11, 22.9%). Escherichia coli was the most common culprit micro-organism. Seventeen (35.4%) infections were poly-microbial. The following factors were found to be associated with the development of SSI after colon resection: male gender (OR: 2.01, 95% CI: 1.03-3.90, p = 0.03), age ≥60 years (OR: 3.18, 95% CI: 1.46-6.89, p = 0.003), pre-operative anemia (hemoglobin <12.5 g/dL) (OR: 4.61, 95% CI: 2.37-8.98, p = < 0.0001), leukocytosis (white blood cell count ≥10,100/mm³) (OR: 0.04, 95% CI: 0.02-0.11, p < 0.0001), thrombocytosis (thrombocytes ≥450,000/mm³) (OR: 39.35, 95% CI: 10.69-144.86, p < 0.0001), peritoneal contamination (OR: 4.11, 95% CI: 2.12-7.97, p < 0.0001).

In addition to other known risk factors (male gender, age over 60 years, pre-operative anemia, leukocytosis, gross peritoneal contamination), this study identified thrombocytosis as a new risk factor for SSI after colon resection.