Effect of perioperative hyperglycemia on surgical site infection in abdominal surgery: A prospective cohort study

Surgical site infection (SSI) remains one of the most frequent complications in abdominal surgery, and hyperglycemia prevention is recommended as a measure to reduce this type of infection. The aims of this study were to estimate the incidence of SSI and to identify the effect of perioperative hyperglycemia on the incidence of this type of infection in patients undergoing abdominal surgery.

We enrolled 484 abdominal surgery patients ≥ 18 years of age, recruited between July 2016 and May 2017. Data were collected through structured interviews and patient assessments in the perioperative period and at the surgical outpatient clinic (30th day after surgery). Crude and adjusted models were built to identify the effect of hyperglycemia on SSI.

The incidence rate of SSI was 20.25%. The attributable fraction for patients exposed to hyperglycemia was >60%. In the multivariable analysis, patients with hyperglycemia, at the end of the surgery and 12 hours later, were more likely to develop this type of infection (relative risk = 1.89 and 2.17, respectively).

Perioperative hyperglycemia was identified as an independent risk factor for SSI. The evidence generated reinforces the importance of proper glycemic control management in the perioperative period for the prevention of SSI.