Department of Surgery, Jersey Shore University Medical Center, Robert Wood Johnson Medical School, Neptune, New Jersey, USA.
Surg Infect (Larchmt). 2011 Dec;12(6):429-34. doi: 10.1089/sur.2011.020. Epub 2011 Sep 20.
The administration of appropriate antibiotics in a timely fashion with discontinuation post-operatively is the first of the Surgical Care Improvement Project (SCIP) initiatives and was expected to reduce post-operative infections significantly. This study aimed at determining whether SCIP has had an effect on surgical site infections (SSIs).
A retrospective cohort study was conducted to evaluate the infection rates of adult patients (age≥18 years) having elective cholecystectomies, laparoscopic cholecystectomies, and colectomies from 2001-2006 using the Nationwide Inpatient Sample (NIS) database. The population consisted of all patients older than 18 years who had colon resection or cholecystectomy and were discharged from a hospital included in the NIS. Annual infection rates were determined for each of the operations.
Post-operative infections rose steadily and significantly (p<0.0001) in colon surgery from 2001 to 2006. A significant increase in SSIs also was seen in open (p=0.0001) and laparoscopic (p<0.0001) cholecystectomy from 2001 to 2006. Length of stay was significantly longer in infected than in non-infected patients.
The factors that contributed to the observed increase in the infection rate should be identified to improve the SCIP initiatives.
及时给予适当的抗生素治疗并在术后停药是外科护理改进项目（SCIP）倡议的首要任务，预计这将显著降低术后感染率。本研究旨在确定 SCIP 是否对手术部位感染（SSI）产生了影响。
本研究采用回顾性队列研究，使用全国住院患者样本（NIS）数据库评估 2001-2006 年择期行胆囊切除术、腹腔镜胆囊切除术和结肠切除术的成年患者（年龄≥18 岁）的感染率。该人群包括所有年龄大于 18 岁且在 NIS 包含的医院出院的接受结肠切除术或胆囊切除术的患者。确定了每种手术的年度感染率。
2001 年至 2006 年，结肠手术的术后感染率呈稳步显著上升（p<0.0001）。2001 年至 2006 年，开放（p=0.0001）和腹腔镜（p<0.0001）胆囊切除术的 SSI 也显著增加。感染患者的住院时间明显长于未感染患者。
应确定导致观察到的感染率增加的因素，以改进 SCIP 计划。
