Daijiworld Media Network – New Delhi

New Delhi, Jul 23: Children whose primary language is neither English nor Spanish may face a significantly higher risk of developing surgical site infections (SSIs) after gastrointestinal surgery, according to a new study that also highlights the need for paediatric-specific infection risk models.

The case-control study analysed 246 patients aged from birth to 21 years who underwent gastrointestinal surgery between 2019 and 2022 at a tertiary paediatric referral centre. The procedures included appendix, gastric, small bowel, colon and exploratory laparotomy surgeries.

Researchers compared 82 children who developed surgical site infections within 30 days of surgery with 164 matched controls. The participants were matched based on age, prematurity, type of procedure and year of surgery.

After adjusting for multiple factors, the researchers found that speaking a primary language other than English or Spanish was the only factor significantly associated with an increased risk of infection. These patients had more than four times the adjusted odds of developing a surgical site infection compared with the control group.

The non-English, non-Spanish language group included speakers of Mandarin, Cantonese, Farsi, Arabic, Mixteco Alto, Mixteco Bajo and Triqui Bajo. Spanish-speaking children did not show a higher risk of infection.

The study also found that children who developed surgical site infections experienced substantially poorer postoperative outcomes. Their median hospital stay was 17.5 days, compared with seven days for children who did not develop infections.

In addition, the 30-day readmission rate was significantly higher among children with infections, at 26 per cent, compared with 10 per cent in the control group.

Researchers noted that infection-prevention practices, including antibiotic prophylaxis, preoperative bathing and skin preparation, were broadly similar between both groups, suggesting these measures did not explain the difference in infection rates.

The study further found that several commonly used adult risk factors, including diabetes, obesity and American Society of Anesthesiologists (ASA) physical status scores, were not significant predictors of surgical site infections in children.

The researchers cautioned that the findings were based on a single-centre retrospective study with a relatively small sample size, limiting conclusions about cause and effect. They also noted that the study could not assess the use of interpreter services during patient interactions, and the broad grouping of different languages may have masked differences among individual communities.

Despite these limitations, the researchers said the findings underscore the importance of language-concordant communication during perioperative care and the need for stronger multilingual support. They also called for the development of paediatric-specific infection risk models that incorporate social and demographic factors instead of relying primarily on models designed for adults.