Evaluation of serum cholesterol levels as risk factors for developing surgical site infection following elective surgery

Bharat Sharma; Mahinder Pal Kochar; Piyush Gupta; Javed Ali Khan; Soma Ram  Choudhary; Brijesh Kumar Sharma

doi:10.18203/2349-2902.isj20252279

Authors

Bharat Sharma Department of General Surgery, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
Mahinder Pal Kochar Department of General Surgery, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
Piyush Gupta Department of General Surgery, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
Javed Ali Khan Department of General Surgery, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
Soma Ram Choudhary Department of General Surgery, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
Brijesh Kumar Sharma Department of General Surgery, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20252279

Keywords:

Hypocholesterolemia, Hypercholesterolemia, Normal cholesterol, Surgical site infection

Abstract

Background: Surgical site infections (SSIs) occur within 30 days of surgery or within one year if a prosthesis is implanted. They are classified as superficial, deep, or organ-space infections. Factors such as wound class, blood transfusion, ostomy creation, operation type, drainage use, patient sex, and surgeon expertise influence SSI risk. This study evaluates preoperative serum cholesterol levels as a potential SSI risk factor.

Methods: Cholesterol levels were measured preoperatively in 100 patients undergoing elective surgery. Postoperative surgicalsite wound swabs identified infecting organisms. Hospital stay duration and ICU requirement were recorded.

Results: Among 100 patients (68 males, 32 females), SSI rates varied by cholesterol status. In the hypocholesterolemia group (n=26), 11 (42.3%) developed SSI. In the hypercholesterolemia group (n=18), 2 (11.1%) developed SSI. In patients with normal cholesterol (n=56), 5 (8.9%) developed SSI. The correlation between cholesterol levels and SSI was statistically significant (p=0.00087). S. aureus (including MRSA) was the most common organism. Hypocholesterolemia patients had longer hospital and ICU stays. These findings align with existing literature.

Conclusions: Low serum cholesterol and albumin levels are significant risk factors for SSIs. Larger studies evaluating lipid subtypes are needed to enhance SSI risk stratification. Limitations were small sample size, heterogeneous procedures, comorbidities, nutritional status variations, inconsistent cholesterol measurement timing, and lack of lipid fraction analysis. Limited interventional data restricts clinical application.

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