Transplantation and Hepatobiliary Center, University of Kentucky College of Medicine, 800 Rose Street, Lexington, KY 40536-0293, USA.
HPB (Oxford). 2012 Feb;14(2):136-41. doi: 10.1111/j.1477-2574.2011.00417.x. Epub 2011 Dec 13.
Postoperative infections are frequent complications after liver resection and have significant impact on length of stay, morbidity and mortality. Surgical site infection (SSI) is the most common nosocomial infection in surgical patients, accounting for 38% of all such infections.
This study aimed to identify predictors of SSI and organ space SSI after liver resection.
Data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for patients who underwent liver resection in 2005, 2006 or 2007 in any of 173 hospitals throughout the USA were analysed. All patients who underwent a segmental resection, left hepatectomy, right hepatectomy or trisectionectomy were included.
The ACS-NSQIP database contained 2332 patients who underwent hepatectomy during 2005-2007. Rates of SSI varied significantly across primary procedures, ranging from 9.7% in segmental resection patients to 18.3% in trisectionectomy patients. A preoperative open wound, hypernatraemia, hypoalbuminaemia, elevated serum bilirubin, dialysis and longer operative time were independent predictors for SSI and for organ space SSI.
These findings may contribute towards the identification of patients at risk for SSI and the development of strategies to reduce the incidence of SSI and subsequent costs after liver resection.
术后感染是肝切除术后常见的并发症，对住院时间、发病率和死亡率有重大影响。手术部位感染（SSI）是外科患者中最常见的医院获得性感染，占所有此类感染的 38%。
本研究旨在确定肝切除术后 SSI 和器官间隙 SSI 的预测因素。
分析了美国外科医师学会全国手术质量改进计划（ACS-NSQIP）数据库中 2005 年、2006 年或 2007 年在美国 173 家医院接受肝切除术的患者的数据。所有接受节段切除术、左肝切除术、右肝切除术或三叶切除术的患者均包括在内。
ACS-NSQIP 数据库包含 2005-2007 年间接受肝切除术的 2332 名患者。SSI 发生率在主要手术中差异显著，从节段切除术患者的 9.7%到三叶切除术患者的 18.3%不等。术前开放性伤口、高钠血症、低白蛋白血症、血清胆红素升高、透析和手术时间延长是 SSI 和器官间隙 SSI 的独立预测因素。
这些发现可能有助于识别发生 SSI 的风险患者，并制定策略来降低肝切除术后 SSI 的发生率和随后的成本。
