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Association between Postoperative Hypotension and Development of Surgical Site Infection after Cesarean Section
Abstract Number: O1-2
Abstract Type: Original Research
Introduction: Cesarean section (CS) delivery is associated with a high rate of surgical site infection (SSI). The incidence of SSI varies but ranges from 3% to 20% (1). There is increasing awareness of the need to reduce SSI given that development of this complication adversely affects the length of hospitalization, quality of life, other major postoperative outcomes, and cost (2). Additionally, there has been no clear consensus on the risk factors contributing to SSI following CS delivery. There is no study evaluating systolic blood pressure and SSI after CS delivery in the literature. Therefore, we aimed to assess the association between systolic blood pressure and SSI.
Method: We obtained data on singleton pregnancy undergoing elective cesarean section under spinal anesthesia at the University of Texas Medical Branch between 2013 and 2016. Incarcerated patients, pre-existing infection and <24 gestational weeks were excluded from the study. The dataset consisted of de-identified electronic medical records of 307527 in-patient encounters. We used all recorded blood pressure measurements form admission to hospital discharge in this analysis. Primarily, we were interested in whether there was an association between average systolic pressure and the likelihood of an infection flag using a logistic regression model. All analyses were performed using SAS Version 9.4.
Result: The dataset consisted of 5499 patients admitted for delivery. We found that every one-point increase in the average systolic blood pressure was associated with a 2.6% increase in the odds of the infection, OR = 1.026 [1.0205 1.0317], p<.0001. Figure 1 below graphically describes the relationship between average systolic blood pressure in stay and the probability of infection.
Discussion: To our knowledge, this is the first study to assess the association between systolic blood pressure and SSI after cesarean section delivery. We found that higher average systolic blood pressure is associated with higher infection rate.
1. Opøien HK, et al. Post-cesarean surgical site infections according to CDC standards: rates and risk factors. A prospective cohort study. Acta Obstet Gynecol Scand 2007.
2. Perencevich EN, et al. Health and economic impact of surgical site infections diagnosed after hospital discharge. Emerg Infect Dis 2003.