Frequency and analysis of the surgical site infections after caesar cell at the Clinic for gynecology and obstetrics of the Clinical hospital center Rijeka

UVOD: Infekcija kirurškog mjesta jedna je od najznačajnijih komplikacija carskog reza, a globalna incidencija iznosi 2-15%. Životna dob veća od 40 godina, vremensko trajanje carskog reza duže od 60 minuta i prijevremena ruptura membrane značajno povećavaju rizik od razvoja infekcije kirurškog mjesta nakon carskog reza. CILJ: Cilj istraživanja bio je ispitati učestalost infekcija kirurškog mjesta nakon carskog reza na Klinici za ginekologiju i porodništvo Kliničkog bolničkog centra Rijeka te istu usporediti s incidencijom u drugim zemljama svijeta. Specifični ciljevi istraživanja bili su usporediti incidenciju infekcija kirurškog mjesta nakon carskog reza prema dobi ispitanica, s obzirom na duljinu trajanja operativnog zahvata te s obzirom na prijevremenu rupturu membrane. METODE: U istraživanju su korišteni podaci prikupljeni iz bolničkog informatičkog sustava Kliničkog bolničkog centra Rijeka u periodu od 01.01.2016. do 31.12.2021. godine. Statistička obrada podataka provela se pomoću programa Statistica (Version 13.5.0.17, 1984-2018 TIBCO Software Inc), a dobiveni podatci prikazani su pomoću tablica i grafova. Hipoteze su testirane metodama deskriptivne statistike, z testom i Hi-kvadrat testom za nezavisne uzroke na razini statističke značajnosti p < 0,05 (5%). REZULTATI: U razdoblju od 2016. do 2021. godine na Klinici za ginekologiju i porodništvo Kliničkog bolničkog centra Rijeka provedeno je 14 712 poroda, od čega u prosjeku 23,9% carskim rezom. Incidencija infekcije kirurškog mjesta nakon carskog reza je 2,8%, što je niže od globalne incidencije i incidencije u drugim zemljama. Gotovo svaka treća rodilja starija od 40 godina razvila je infekciju kirurškog mjesta nakon carskog reza, što je 23 puta veća učestalost nego kod rodilja mlađih od 40 godina. Porod carskim rezom je u prosjeku trajao 33,2 minute, a niti jedan carski rez nije trajao duže od 50 min, stoga nije bilo moguće istražiti povezanost s infekcijom kirurškog mjesta. Incidencija infekcije kirurškog mjesta nakon carskog reza kod ispitanica s prijevremenom rupturom membrane je gotovo dvostruko veća (4,5%) nego kod ispitanica s drugim indikacijama za carski rez (2,5%). ZAKLJUČAK: Incidencija infekcije kirurškog mjesta značajno je manja u Kliničkom bolničkom centru Rijeka u usporedbi na ostale zemlje uključene u istraživanja. Životna dob veća od 40 godina i prijevremena ruptura membrane značajno povećavaju rizik od infekcije kirurškog mjesta nakon carskog reza.INTRODUCTION: Surgical site infection is one of the most significant complications of caesarean section, with a global incidence of 2-15%. Age greater than 40 years, duration of caesarean section longer than 60 minutes and premature rupture of the membrane significantly increases the risk of developing a surgical site infection after caesarean section. OBJECTIVE: The aim of the research was to examine the frequency of surgical site infections after caesarean section at the Clinic for Gynecology and Obstetrics of the Clinical Hospital Center Rijeka and to compare it with the incidence in other countries of the world. The specific objectives of the study were to compare the incidence of surgical site infections after caesarean section according to the age of the subjects, regarding the duration of the operative procedure and regarding premature rupture of the membrane. METHODS: The research used data collected from the hospital IT system of the Rijeka Clinical Hospital Center in the period from January 1, 2016. until 31.12.2021. years. Statistical data processing was carried out using the Statistica program (Version 13.5.0.17, 1984-2018 TIBCO Software Inc), and the obtained data were presented using tables and graphs. Hypotheses were tested using the methods of descriptive statistics, the z test, and the Chi-square test for independent causes at the level of statistical significance p < 0.05 (5%). RESULTS: In the period from 2016 to 2021, 14,712 births were performed at the Clinic for Gynecology and Obstetrics of the Rijeka Clinical Hospital Center, of which, on average, 23.9% were by caesarean section. The incidence of surgical site infection after caesarean section is 2.8%, which is lower than the global incidence and the incidence in other countries. Almost every third woman in labor over the age of 40 developed a surgical site infection after a caesarean section, which is 23 times higher than in women under 40. Cesarean delivery lasted 33.2 minutes on average, and no cesarean section lasted longer than 50 minutes, so it was not possible to investigate the connection with surgical site infection. The incidence of surgical site infection after cesarean section in subjects with premature rupture of membranes is almost twice as high (4.5%) as in subjects with other indications for cesarean section (2.5%). CONCLUSION: The incidence of surgical site infection is significantly lower in the Rijeka Clinical Hospital Center compared to other countries included in the research. Age greater than 40 years and premature rupture of membranes significantly increase the risk of surgical site infection after caesarean section