Kaye Keith S, Schmit Kristine, Pieper Carl, Sloane Richard, Caughlan Kathleen F, Sexton Daniel J, Schmader Kenneth E
Division of Infectious Diseases, Department of Medicine, School of Medicine, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina 27710, USA.
J Infect Dis. 2005 Apr 1;191(7):1056-62. doi: 10.1086/428626. Epub 2005 Feb 24.
An increasing number of older persons undergo surgery, but the relationship between increasing age and risk of surgical site infection (SSI) has not been established. The objective of the present study was to determine the relationship between increasing age and risk of SSI.
The present cohort study included patients who underwent surgery between February 1991 and July 2002. Patients >17 years of age were divided randomly into derivation and validation cohorts. The study was conducted at 11 hospitals. SSIs were prospectively identified by use of Centers for Disease Control and Prevention criteria.
The study included 144,485 consecutive surgical patients and 1684 SSIs (rate of SSI, 1.2%). There were 72,139 procedures and 873 SSIs in the derivation cohort. Adjusted analyses revealed a significant relationship between age and risk of SSI (P=.006). Risk of SSI increased by 1.1%/year between ages 17 and 65 years (P=.002). At age >/=65 years, risk of SSI decreased by 1.2% for each additional year (P=.008). There were 72,334 procedures and 811 SSIs in the validation cohort. The relationship between age and risk of SSI was similar in the validation cohort.
Increasing age independently predicted an increased risk of SSI until age 65 years. At ages >/=65 years, increasing age independently predicted a decreased risk of SSI.
接受手术的老年人数量日益增加，但年龄增长与手术部位感染（SSI）风险之间的关系尚未明确。本研究的目的是确定年龄增长与SSI风险之间的关系。
本队列研究纳入了1991年2月至2002年7月期间接受手术的患者。年龄大于17岁的患者被随机分为推导队列和验证队列。研究在11家医院进行。采用疾病控制与预防中心的标准对SSI进行前瞻性识别。
该研究纳入了144485例连续的手术患者，其中1684例发生SSI（SSI发生率为1.2%）。推导队列中有72139例手术和873例SSI。校正分析显示年龄与SSI风险之间存在显著关系（P = 0.006）。17岁至65岁之间，SSI风险每年增加1.1%（P = 0.002）。在年龄≥65岁时，每增加一岁，SSI风险降低1.2%（P = 0.008）。验证队列中有72334例手术和811例SSI。验证队列中年龄与SSI风险之间的关系相似。
在65岁之前，年龄增长独立预测SSI风险增加。在年龄≥65岁时，年龄增长独立预测SSI风险降低。
