Ketcheson et al identified risk factors for a surgical site infection following a cesarean delivery. These can help to identify a woman who may benefit from more aggressive management. The authors are from Dalhousie University in Halifax, Nova Scotia.
Patient selection: cesarean section
Outcome: surgical site infection (SSI) within 30 days, with incidence 2.7%
Risk factors for SSI based on multivariate analysis (based on odds ratio >= 1.5):
(1) obesity (prepregnancy weight >= 87 kilograms)
(2) weight gain >= 30 kg during pregnancy
(3) chorioamnionitis
(4) maternal blood transfusion
(5) anticoagulation therapy during the pregnancy
(6) substance abuse (alcohol or drug)
(7) in second stage of labor prior to cesarean section
(8) delivey at a hospital with 130 to 1249 cesarean deliveries per year
(9) pre-existing diabetes
Risk factors for SSI presenting before hospital discharge:
(1) >= 130 cesarean deliveries per year at the hospital
(2) 2 or more fetuses
Risk factors for SSI presenting after hospital discharge:
(1) smoking.
