TITLE:
Cesarean Section Incision Complications and Associated Risk Factors: A Quality Assurance Project
AUTHORS:
Charles Newlin, Thomas J. Kuehl, Anthony Pickrel, Chase R. Cawyer, Richard O. Jones
KEYWORDS:
Cesarean Wound Infection, Cesarean Wound Complication, Preeclampsia, Risk Factors
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.5 No.14,
November
30,
2015
ABSTRACT: Background: Today in the United States, approximately 30% of deliveries
are performed by cesarean section. Wound infections and other post-operative complications
represent a frequent morbidity which may be improved with an understanding of
local risk factors. Objective: This project used a retrospective analysis of
cesarean section incision complications and infection events along with patient
chart information to identify potential risk factors associated with incisional
wound complications at our institution. Methods: ICD9 codes identified 618
cesarean sections from July 2012 through June 2013. Of these, 59 were excluded.
Twelve different data elements were examined and complications were divided
into two categories: presence of infection and presence of seroma/hematoma.
Statistics included univariate analysis and multiple logistic regressions to
identify an odds ratio for associations using P complications.
Three of the five variables had a significant odds ratio: emergent cesarean
section, stapled skin closure, and preeclampsia. Five logistic variables were
included in another multiple logistic regression model for all wound infections. Two of the five variables
had a significant odds ratio: BMI > 33.4 and preeclampsia. Conclusions:
Cesarean section rates account for approximately 30% of deliveries, with
significant maternal morbidity associated with incisional wound complications.
This study found multiple significant risk factors for both wound complications
and infections. Preeclampsia was an independent risk factor for both wound
complications and infections.