Departement de Biostatistique et Informatique Medicale, Hopital Saint-Louis, AP-HP, Paris, France.
Int Orthop. 2012 Jun;36(6):1155-61. doi: 10.1007/s00264-011-1444-y. Epub 2011 Dec 30.
Infection of a total hip replacement is potentially a devastating complication. Statistical process control methods have been generating interest as a means of improving the quality of healthcare, and we report our experience with the implementation of such a method to monitor the one year infection rate after primary total hip replacement.
Infection was defined as the growth of the same organism in cultures of at least two aspirates or intra-operative specimens, or growth of one pathogen in a patient with local signs of infection such as erythema, abscess or draining sinus tract. The cumulative summation test (CUSUM test) was used to continuously monitor the one year postoperative infection rate. The target performance was 0.5% and the test was set to detect twice that rate.
Over the three year study period, 2006 primary total hip replacements were performed. Infection developed within one year after surgery in eight (0.4%) hips. The CUSUM test generated no alarms during the study period, indicating that there was no evidence that the process was out of control.
The one year infection rate after primary total hip replacement was in control. The CUSUM test is a useful method to continuously ensure that performance is maintained at an adequate level.
人工髋关节置换术后感染是一种潜在的破坏性并发症。统计过程控制方法已成为提高医疗保健质量的一种手段，我们报告了实施这种方法来监测初次全髋关节置换术后 1 年感染率的经验。
感染定义为至少两次抽吸或术中标本培养出相同的病原体，或在有局部感染迹象（如红斑、脓肿或窦道引流）的患者中一种病原体的生长。累积和检验（CUSUM 检验）用于连续监测术后 1 年的感染率。目标性能为 0.5%，检测设定为检测两倍的速率。
在三年的研究期间，共进行了 2006 例初次全髋关节置换术。术后一年内有 8 例（0.4%）髋关节发生感染。在研究期间，CUSUM 检验没有发出警报，表明没有证据表明该过程失控。
初次全髋关节置换术后 1 年的感染率得到了控制。CUSUM 检验是一种有用的方法，可以持续确保性能保持在适当水平。
