Llanos Méndez Aurora, Díaz Molina Carmen, Fernández-Crehuet Navajas Rafael
Agencia de Evaluación de Tecnologías Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, España.
Cir Esp. 2010 Nov;88(5):319-27. doi: 10.1016/j.ciresp.2010.08.004. Epub 2010 Oct 14.
Surgical site infection (SSI) is a very common problem in hospital infection control. It represents a risk for the safety of the patient and therefore its reduction is a priority in Health Services. The aim of the study is to analyse the incidence of SSI in the surgical departments of a tertiary hospital.
A prospective cohort study was conducted on 14,455 patients admitted from January 2001 to December 2004. The cumulative incidence (CI) crude and adjusted for the National Nosocomial Infection Surveillance (NNIS) index and the incidence density (ID) of SSI were calculated.
The CI of patients with SSI was 3.4% (95% CI: 3.0-3.7%), the CI of SSI was 3.5% and the observed ID was 0.28/100 surgical patients/day. Surgical units with the highest CI were maxillofacial (6%), gastrointestinal (5.3%) and cardiovascular (5.1%). Adjusting for length of stay, urology and paediatric surgery recorded the highest incidence rates, while ophthalmology and neurosurgery had the least. Colorectal surgery had the highest parameters (CI=10%; ID=0.57), followed by myocardial revascularisation and hip prosthesis. Among the surgical units and operative procedures assessed, the CI of SSI increased with the NNIS index.
The CI and ID of SSI observed in this study were similar to those obtained in previous European surveillance projects, and lower than those recorded in our hospital in 1994 which reflects a higher level of vigilance and a higher awareness in applying control measures.
手术部位感染(SSI)是医院感染控制中非常常见的问题。它对患者安全构成风险,因此降低其发生率是卫生服务的优先事项。本研究的目的是分析一家三级医院外科科室中SSI的发生率。
对2001年1月至2004年12月收治的14455例患者进行了前瞻性队列研究。计算了未调整的累积发病率(CI)以及根据国家医院感染监测(NNIS)指数调整后的累积发病率和SSI的发病密度(ID)。
SSI患者的CI为3.4%(95%CI:3.0 - 3.7%),SSI的CI为3.5%,观察到的ID为0.28/100手术患者/天。CI最高的外科科室是颌面外科(6%)、胃肠外科(5.3%)和心血管外科(5.1%)。调整住院时间后,泌尿外科和小儿外科的发病率最高,而眼科和神经外科的发病率最低。结直肠手术的各项参数最高(CI = 10%;ID = 0.57),其次是心肌血运重建术和髋关节置换术。在评估的外科科室和手术操作中,SSI的CI随NNIS指数增加。
本研究中观察到的SSI的CI和ID与先前欧洲监测项目中获得的结果相似,且低于我院1994年记录的结果,这反映了更高的警惕性以及在应用控制措施方面更高的认识。