Erman Tahsin, Demirhindi Hakan, Göçer A Iskender, Tuna Metin, Ildan Faruk, Boyar Bülent
Department of Neurosurgery, School of Medicine, Cukurova University, Balcali-Adana 01330, Turkey.
Surg Neurol. 2005 Feb;63(2):107-12; discussion 112-3. doi: 10.1016/j.surneu.2004.04.024.
This prospective study aimed to determine the spectrum and the main risk factors of surgical site infection (SSI) after neurosurgical procedures in our clinic.
Consecutive patients undergoing neurosurgery between November 1, 2001, and November 1, 2002, were recruited for the study. All patients were followed for a minimum of 2 weeks postoperatively and all SSIs were recorded. The complete medical records of each case were reviewed, and data on 14 possible risk factors were extracted. Statistical analyses were performed to identify the risk factors for SSIs.
A total of 31 postoperative SSIs were identified among 503 cases included in the study, with a resulting overall infection rate of 6.2%. The risk of SSI was increased by age (odds ratio [OR], 1.1; 95% confidence interval [CI], 1.0-1.1; P = .039), operation type such as "shunt operations" (OR, 670.4; 95% CI, 2.6-171123.1; P = .021), presence of foreign body (OR, 141.0; 95% CI, 2.5-7925.9; P = .016), presence of diabetes mellitus (OR, 24.3; 95% CI, 2.1-284.9; P = .011), and intracranial pressure monitoring (OR, 4878.9; 95% CI, 23.8-1001229; P = .002). The predominantly isolated microorganisms in patients with SSIs were Staphylococcus aureus (22 [71.0%]), Acinetobacter baumanii (5 [16.1%]), and Staphylococcus epidermidis (4 [12.9%]).
SSIs remain an important problem in neurosurgery. Identification of the risk factors for SSI will help physicians to improve patient care and may decrease mortality, morbidity, and health care costs of neurosurgery patients.
本前瞻性研究旨在确定我院神经外科手术后手术部位感染（SSI）的范围及主要危险因素。
选取2001年11月1日至2002年11月1日期间连续接受神经外科手术的患者进行研究。所有患者术后至少随访2周，并记录所有手术部位感染情况。查阅每个病例的完整病历，提取14种可能危险因素的数据。进行统计分析以确定手术部位感染的危险因素。
在纳入研究的503例病例中，共发现31例术后手术部位感染，总体感染率为6.2%。年龄（比值比[OR]，1.1；95%置信区间[CI]，1.0 - 1.1；P = 0.039）、“分流手术”等手术类型（OR，670.4；95% CI，2.6 - 171123.1；P = 0.021）、异物存在（OR，141.0；95% CI，2.5 - 7925.9；P = 0.016）、糖尿病存在（OR，24.3；95% CI，2.1 - 284.9；P = 0.011）以及颅内压监测（OR，4878.9；95% CI，23.8 - 1001229；P = 0.002）会增加手术部位感染的风险。手术部位感染患者中主要分离出的微生物为金黄色葡萄球菌（22株[71.0%]）、鲍曼不动杆菌（5株[16.1%]）和表皮葡萄球菌（4株[12.9%]）。
手术部位感染仍是神经外科的一个重要问题。识别手术部位感染的危险因素将有助于医生改善患者护理，并可能降低神经外科患者的死亡率、发病率和医疗费用。
