Astagneau P, Rioux C, Golliot F, Brücker G
Inter-regional co-ordinating Centre for Nosocomial Infection Control (C-CLIN Paris Nord), Paris, France.
J Hosp Infect. 2001 Aug;48(4):267-74. doi: 10.1053/jhin.2001.1003.
Since 1997, a surgical-site infections (SSI) surveillance network (INCISO) has been implemented in volunteer general surgical units in Northern France. For three months each year, all patients who undergo a surgical procedure are consecutively reviewed for their peri-operative condition and traced for outcome with a 30-day follow-up. Of the 38973 surgical patients included over a three-year period, 1344 (3.4%) developed SSI and 568 died (1.5%) including 78 with an SSI. Organ-space and deep incisional SSI were associated with a higher mortality and required re-operation more frequently than did superficial incisional SSI. SSI incidence and mortality varied according to the surgical procedure. SSI was a significant predictor of mortality, independently of NNIS risk index and other survival predictors. Thirty-eight percent of deaths in SSI patients were attributable to infection. Hence, the significant impact of SSI on mortality and morbidity in surgical patients is now an additional reason to reinforce compliance of surgical staff with preventive measures and hygiene practices.
自1997年以来，法国北部的志愿普通外科病房实施了一个手术部位感染（SSI）监测网络（INCISO）。每年有三个月的时间，对所有接受外科手术的患者的围手术期情况进行连续评估，并对其结果进行为期30天的随访追踪。在三年期间纳入的38973例外科手术患者中，1344例（3.4%）发生了手术部位感染，568例死亡（1.5%），其中78例伴有手术部位感染。器官腔隙感染和深部切口感染比浅表切口感染的死亡率更高，且更常需要再次手术。手术部位感染的发生率和死亡率因手术方式而异。手术部位感染是死亡率的一个重要预测因素，独立于国家医院感染监测系统（NNIS）风险指数和其他生存预测因素。手术部位感染患者中38%的死亡归因于感染。因此，手术部位感染对外科手术患者死亡率和发病率的重大影响，现在成为加强外科工作人员对预防措施和卫生规范依从性的又一个理由。
