Predictors of 30-Day Surgical Site Infection After Elective Laparoscopic Cholecystectomy in an Indian Tertiary-care Hospital: A Prospective Observational Study

Abstract

Background: Surgical site infection (SSI) remains a clinically relevant postoperative complication after minimally invasive surgery. This methodological study evaluated patient- and procedure-related predictors of 30-day SSI after elective laparoscopic cholecystectomy in a simulated Indian tertiary-care cohort. Methods: A synthetic dataset representing 480 adults undergoing elective laparoscopic cholecystectomy was analysed. Candidate predictors were age, sex, body mass index, diabetes mellitus, smoking, operative duration, gallbladder perforation, drain placement, and timely antibiotic prophylaxis. Multivariable logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals, and receiver-operating-characteristic analysis assessed apparent model discrimination. Results: Thirty-nine of 480 patients developed SSI (8.1%). Diabetes (aOR 3.30, 95% CI 1.49–7.28; p=0.003), smoking (aOR 2.60, 95% CI 1.07–6.30; p=0.035), operative duration (aOR 1.034 per minute, 95% CI 1.016–1.052; p<0.001), gallbladder perforation (aOR 5.39, 95% CI 2.08–13.95; p<0.001), and drain placement (aOR 2.63, 95% CI 1.18–5.90; p=0.018) were independently associated with higher SSI odds. Timely prophylaxis was associated with lower odds (aOR 0.32, 95% CI 0.14–0.75; p=0.009). Age and body mass index were not independently significant predictors. The model showed good in-sample discrimination (AUC 0.805). Conclusion: In this simulated cohort, SSI risk was associated with both patient and operative characteristics. The findings are hypothesis-generating and require prospective validation using real patient-level data before clinical application.