Gaynes R P, Culver D H, Horan T C, Edwards J R, Richards C, Tolson J S
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Clin Infect Dis. 2001 Sep 1;33 Suppl 2:S69-77. doi: 10.1086/321860.
By use of the National Nosocomial Infections Surveillance (NNIS) System's surgical patient surveillance component protocol, the NNIS basic risk index was examined to predict the risk of a surgical site infection (SSI). The NNIS basic SSI risk index is composed of the following criteria: American Society of Anesthesiologists score of 3, 4, or 5; wound class; and duration of surgery. The effect when a laparoscope was used was also determined. Overall, for 34 of the 44 NNIS procedure categories, SSI rates increased significantly (P< .05) with the number of risk factors present. With regard to cholecystectomy and colon surgery, the SSI rate was significantly lower when the procedure was done laparoscopically within each risk index category. With regard to appendectomy and gastric surgery, use of a laparoscope affected SSI rates only when no other risk factors were present. The NNIS basic SSI index is useful for risk adjustment for a wide variety of procedures. For 4 operations, the use of a laparoscope lowered SSI risk, requiring modification of the NNIS basic SSI risk index.
通过使用国家医院感染监测（NNIS）系统的手术患者监测部分方案，对NNIS基本风险指数进行了检查，以预测手术部位感染（SSI）的风险。NNIS基本SSI风险指数由以下标准组成：美国麻醉医师协会评分为3、4或5；伤口类别；以及手术持续时间。还确定了使用腹腔镜时的影响。总体而言，在44个NNIS手术类别中的34个类别中，SSI发生率随着存在的风险因素数量显著增加（P<0.05）。对于胆囊切除术和结肠手术，在每个风险指数类别中，腹腔镜手术时的SSI发生率显著更低。对于阑尾切除术和胃手术，仅在不存在其他风险因素时，使用腹腔镜才会影响SSI发生率。NNIS基本SSI指数对于多种手术的风险调整很有用。对于4种手术，使用腹腔镜降低了SSI风险，这需要对NNIS基本SSI风险指数进行修改。
