• Manuel C Vallejo, Ahmed F Attaallah, Robert E Shapiro, Osama M Elzamzamy, Michael G Mueller, and Warren S Eller.
• Department of Medical Education, Robert C. Byrd Health Sciences Center, School of Medicine, West Virginia University, PO Box 9001A, Morgantown, WV, 26506, USA. mcvallejo@hsc.wvu.edu.
• J Anesth. 2017 Feb 1; 31 (1): 120-126.

BackgroundWe aimed to determine the incidence of surgical site infection (SSI) after cesarean delivery (CD) and identify the risk factors in a rural population.MethodsWe identified 218 SSI patients by International Classification of Disease codes and matched them with 3131 parturients (control) from the electronic record database in a time-matched retrospective quality assurance analysis.Results And DiscussionThe incidence of SSI after CD was 7.0 %. Risk factors included higher body mass index (BMI) [40.30 ± 10.60 kg/m2 SSI (95 % CI 38.73-41.87) vs 34.05 ± 8.24 kg/m2 control (95 % CI 33.75-34.35, P < 0.001)], years of education [13.28 ± 2.44 years SSI (95 % CI 12.9-13.66) vs 14.07 ± 2.81 years control (95 % CI 13.96-14.18, P < 0.001)], number of prior births [2 (1-9) SSI vs 1 (1-11) control (P < 0.001)], tobacco use (OR 1.49; 95 % CI 1.06-2.09, P = 0.03), prior diagnosis of hypertension (OR 1.80; 95 % CI 1.34-2.42, P < 0.001), gestational diabetes (OR 1.59; 95 % CI 1.18-2.13, P = 0.003), and an emergency/STAT CD (OR 1.6; 95 % CI 1.1-2.3, P = 0.01).ConclusionsRisk factors for SSI after CD included higher BMI, less years of education, higher prior births, tobacco use, prior diagnosis of hypertension, gestational diabetes, and emergency/STAT CD. The presence of ruptured membranes was protective against SSI.

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