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心脏手术后90天术后伤口感染的发生率

Prevalence of 90-days postoperative wound infections after cardiac surgery.

作者信息

Jonkers Daisy, Elenbaas Ted, Terporten Peter, Nieman Fred, Stobberingh Ellen

机构信息

Department of Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands.

出版信息

Eur J Cardiothorac Surg. 2003 Jan;23(1):97-102. doi: 10.1016/s1010-7940(02)00662-0.

Abstract

OBJECTIVE

Postoperative wound infections generally cause considerable extra morbidity, mortality and costs. As nowadays length of hospitalization shortens, post-discharge surveillance is important to get reliable information on the prevalence of postoperative wound infections. In this study, the prevalences of sternal wound (SWI) and donor site infections (DSI) during hospitalization as well as, 30 and 90 days after cardiac surgery were studied paying special attention to the contribution of post-discharge surveillance.

METHODS

A total of 1885 patients who underwent cardiac surgery were included in the study and were followed for the prevalence of SWI or DSI up to 90 days postoperatively. Infection data during hospitalization were collected using medical records, bacteriological results and systematic observations of infection control nurses. After discharge from the hospital, data were collected with the help of the out-patient clinic and the family physician.

RESULTS

After cardiac surgery, SWI and DSI were diagnosed in 4.7 and 1.5% of patients during hospitalization, in 6.8 and 4.6% at 30 days postoperatively, and in 9.0 and 7.3% of patients at 90 days postoperatively. Of the 90-days postoperative infections rates almost half of SWI and 80% of DSI were diagnosed post-discharge, a result predominantly achieved by the active participation of the family physicians.

CONCLUSIONS

After 30 and 90 days follow-up of patients after cardiac surgery, additional sternal wound and donor site infections were diagnosed compared with the in-hospital infection rate. Post-discharge surveillance is essential for a reliable assessment of surgical wound infections.

摘要

目的

术后伤口感染通常会导致相当多的额外发病率、死亡率和费用。由于如今住院时间缩短,出院后监测对于获取术后伤口感染患病率的可靠信息很重要。在本研究中,我们研究了心脏手术后住院期间以及术后30天和90天时胸骨伤口感染(SWI)和供区感染(DSI)的患病率,并特别关注出院后监测的作用。

方法

共有1885例接受心脏手术的患者纳入本研究,并对其术后90天内的SWI或DSI患病率进行随访。住院期间的感染数据通过病历、细菌学结果以及感染控制护士的系统观察来收集。出院后,数据通过门诊和家庭医生收集。

结果

心脏手术后,住院期间SWI和DSI的诊断率分别为4.7%和1.5%,术后30天时分别为6.8%和4.6%,术后90天时分别为9.0%和7.3%。在术后90天的感染率中,几乎一半的SWI和80%的DSI是在出院后诊断出来的,这一结果主要是通过家庭医生的积极参与实现的。

结论

对心脏手术后患者进行30天和90天随访后,与住院感染率相比,又诊断出了额外的胸骨伤口和供区感染。出院后监测对于可靠评估手术伤口感染至关重要。

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