Association between preoperative serum albumin and serum cholesterol with surgical site infection: a prospective observational study

Abstract

Background: Surgical site infection (SSI) is one of the most common healthcare-associated infections and a major cause of postoperative morbidity, prolonged hospital stays, and increased healthcare costs. While obesity and hypoalbuminemia are established risk factors for SSI, the roles of serum cholesterol and serum albumin remain controversial. This prospective observational study was conducted to evaluate the association of preoperative serum albumin and serum cholesterol with the incidence of SSI among patients undergoing elective clean-contaminated general surgical procedures at Heritage Institute of Medical Sciences, Varanasi.

Methods: This prospective observational study was conducted over two years at Heritage Institute of Medical Sciences, Varanasi. A total of 150 patients aged 18–65 years undergoing elective clean-contaminated general surgical procedures were enrolled. Demographic characteristics, comorbidities, and preoperative serum albumin and cholesterol levels were recorded. SSI was diagnosed according to Centre for Disease Control (CDC) criteria. Data were analyzed using SPSS version 26.0, and associations between variables were assessed using the Chi-square test, with p<0.05 considered statistically significant.

Results: SSI occurred in 51 (34.0%) of 150 patients. Hypoalbuminemia and abnormal serum cholesterol levels were significantly associated with SSI (p=0.026 and p=0.030, respectively), and postoperative hospital stay was significantly longer among patients with SSI.

Conclusions: Preoperative serum albumin and serum cholesterol are important predictors of surgical site infection following elective clean-contaminated general surgery. Their preoperative assessment and optimization may help reduce postoperative infectious complications and improve surgical outcomes.