SCORING SYSTEM FOR PREDICTED SURGICAL-SITE INFECTION IN NEONATES AND PEDIATRIC INTENSIVE CARE UNIT: A PRELIMINARY STUDY.

Abstract

Background: Surgical-site infections (SSI) account for a large portion of morbidity with the rate of 500,000 cases per year from 27 million surgeries. Some researchers found that factors contributing to surgical wound infections are the number of bacteria contaminants, the bacterias virulence, the micro-environment around the surgical wound, and the immune system of the host.

Objective: To account the risk factors for surgical-site infections in neonatal and pediatric intensive care unit and apply them in a risk index for neonates and pediatrics in critical care unit.

Method: A cohort retrospective study was initiated to investigate risk factors for SSI at Tarakan General Hospital from January 2018 to July 2019. The different factors then analyzed with chi-square test, whereas the multivariate binary logistic regression model was used to examine independent risk factors for SSI.

Result: A total of 179 patients met the inclusion criteria. There were 66 patients in NICU and 113 in PICU. Bivariate analysis showed that SSI was associated with type of ward, operating room temperature, perioperative septicemia, length of stay, and the use of chlorhexidine bath-washing (p<0.05). Multivariate analysis identified three independent parameters correlating with the occurance of SSI: operating room temperature (odds ratio [OR] 12,510; 95% confidence interval [CI] 4,198 37,279; P<0.001); perioperative septicemia (OR 6,424; 95% CI 2,221 18,581; P=0.001); and the use of chlorhexidine bath-washing (OR 35,751; 95% CI 8,627 148,164; P<0.001).

Conclusion: From these three independent paramaters, we recommend a prognostic scoring for SSI in post operative NICUs and PICUs patients that still need another diagnostic, validity and realibility test to improve patients outcome.