COMPARISON OF SURGICAL SITE INFECTION RATES BETWEEN EMERGENCY AND ELECTIVE APPENDECTOMY: A RETROSPECTIVE STUDY
*Moh’ D. Obeidat, Mohammad Alsmadi, Samer Alshufiyyen, Osaid AL-Akhras, Mohammad Abuwandi, Wisam
AL-Sukkar, Nedhal Al_Qadhi, Ban SHA’ Ban
ABSTRACT
Background: Surgical site infections (SSIs) are among the most common postoperative complications and
significantly increase morbidity, length of stay, and healthcare costs. Appendectomy is frequently performed as an
emergency procedure, and its infection risk may vary based on urgency and surgical approach. Aim: This study
aimed to compare SSI rates between emergency and interval (elective) appendectomy and to identify independent
risk factors for postoperative SSI. Methods: We conducted a retrospective cohort study of all appendectomy cases
at King Hussein Medical Center between 2020 and 2023. Patients were categorized as emergency or interval
appendectomy. Data on demographics, comorbidities, operative details, and postoperative outcomes were
collected. SSI was defined per CDC criteria as any superficial, deep, or organ-space infection within 30 days.
Group comparisons used Wilcoxon rank-sum and chi-squared tests, and multivariable logistic regression identified
independent predictors of SSI. Results: Among all cases, laparoscopic surgery was more common in the interval
group (90% vs. 74%), while open surgery was more frequent in emergencies (26% vs. 10%, p < 0.001).
Emergency cases more often involved perforation (20% vs. 4.2%, p < 0.001) and had longer operative times (64
vs. 59 min, p < 0.001) and length of stay (3.4 vs. 2.7 days, p < 0.001). SSIs occurred predominantly after
emergency appendectomy (86% vs. 67%, p < 0.001). Independent predictors of SSI included emergency
presentation (OR 1.99, p = 0.021), open approach (OR 2.27, p < 0.001), perforation (OR 2.19, p = 0.003), diabetes
(OR 2.67, p < 0.001), and longer operative time (OR 1.01 per minute, p = 0.036). Conclusion: Emergency
appendectomy was associated with a significantly higher risk of SSI, especially with open surgery, perforation,
diabetes, and prolonged operative duration. Targeted prevention and prioritization of laparoscopic techniques may
reduce SSI risk.
Keywords: Appendectomy, Surgical Site Infection, Emergency Surgery, Elective Surgery, Risk Factors.
[Full Text Article]
[Download Certificate]
Impact Factor : 8.181 
