Risikofaktorer for postoperative sårinfeksjoner etter keisersnitt i Helse Møre og Romsdal 2020-2024

Abstract

Background The proportion of cesarean sections in Norway has increased significantly over the past 50 years. Given complications such as postoperative wound infections (POSI), identifying risk factors to prevent POSI is of interest. A quality assurance project was therefore conducted to examine potential risk factors for developing POSI after cesarean section. Research Question Which risk factors are associated with the development of postoperative wound infections (POSI) after cesarean section in Helse Møre og Romsdal in the period 2020–2024, and how can the timing of antibiotic prophylaxis affect the infection rate? Sub-questions include risks related to emergency cesarean sections, contamination class, antibiotic prophylaxis, blood loss, and challenges with medical record data. Patients and Methods Data from cesarean sections at hospitals in Helse Møre og Romsdal (Kristiansund, Molde, Ålesund, Volda) were retrieved from the POSI registry (2020–2024). Multivariate analysis assessed factors such as urgency, contamination class, antibiotic prophylaxis, age, operation time, and ASA score. For one hospital, medical record data were additionally analyzed for blood loss (n=39) and timing of antibiotic prophylaxis (n=29). Results The use of antibiotic prophylaxis for cesarean sections varied considerably (Ålesund: 97.3%, Kristiansund: 35.7%). Emergency cesarean sections had twice the risk of POSI compared to non-emergency ones. The use of antibiotic prophylaxis (yes/no) showed no effect. For those receiving early antibiotic prophylaxis (n=29, up to 53 minutes before incision), the risk of POSI increased with each delayed minute (OR per delayed minute = 1.056, 95% CI: 1.002–1.110, p=0.040). All patients without infection received antibiotic prophylaxis before incision. Incomplete medical record documentation limited the analysis. Conclusions and Implications Emergency cesarean sections increase the risk of POSI. Early antibiotic prophylaxis shows a significant reduction in infection risk. Incomplete documentation in medical records complicates the analysis of data. Despite the small dataset, the findings support the need for further research on optimal administration of antibiotic prophylaxis to prevent POSI.