Anannamcharoen Sahaphol, Vachirasrisirikul Sitthichai, Boonya-Assadorn Chinakrit
Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2012 Jan;95(1):42-7.
Knowledge of specific risk factors for incisional Surgical Site Infection (SSI) is essential to create a specific SSI risk stratification index for colorectal surgery patients.
Identify factors increasing the risk of incisional SSI that lead to the development of a more efficient tool for predicting and comparing surgical site infection rates among surgeons and institutions performing the same type of procedure for colorectal surgery patients.
The authors conducted a prospective incisional SSI surveillance in 229 consecutive patients who underwent open colon and rectal resections performed in Phramongkutklao Hospital between October 1, 2008 and September 30, 2010. Independent risk factors for SSIs were identified by multivariate analysis.
The present study identified six independent risk factors significantly associated with a higher risk of incisional SSI that included Body mass index (BMI) > 30 (Odd ratio (OD) = 4.4; 95% confidence interval (CI) = 1.235-15.502; p = 0.022), hypoalbuminemia (< 3.5 g/dl) (Odd ratio (OR) = 2.8; 95% confidence interval (CI) = 1.003-7.587; p = 0.049), Hartmann's procedure (Odd ratio (OR) = 2.6; 95% confidence interval (CI) = 1.037-6.729; p = 0.042), postoperative hypotension, (Odd ratio (OR) = 2.3; 95% confidence interval (CI) = 1.043-5.268; p = 0.039) and postoperative hypothermia (Odd ratio (OR) = 5.6; 95% confidence interval (CI) = 1.112-28.482; p = 0.037).
Risk factors identified in the present study can be considered for creating a specific incisional SSI risk stratification index for colorectal surgery patients. This specific risk stratification index will be a more efficient tool for predicting and comparing SSI rates among surgeons and institutions.
了解切口手术部位感染（SSI）的特定风险因素对于为结直肠手术患者创建特定的SSI风险分层指数至关重要。
确定增加切口SSI风险的因素，从而开发一种更有效的工具，用于预测和比较为结直肠手术患者实施相同类型手术的外科医生和机构之间的手术部位感染率。
作者对2008年10月1日至2010年9月30日在诗里蒙坤贴医院接受开放性结肠和直肠切除术的229例连续患者进行了前瞻性切口SSI监测。通过多变量分析确定SSI的独立风险因素。
本研究确定了六个与切口SSI风险较高显著相关的独立风险因素，包括体重指数（BMI）>30（比值比（OD）=4.4；95%置信区间（CI）=1.235-15.502；p=0.022）、低蛋白血症（<3.5g/dl）（比值比（OR）=2.8；95%置信区间（CI）=1.003-7.587；p=0.049）、哈特曼手术（比值比（OR）=2.6；95%置信区间（CI）=1.037-6.729；p=0.042）、术后低血压（比值比（OR）=2.3；95%置信区间（CI）=1.043-5.268；p=0.039）和术后体温过低（比值比（OR）=5.6；95%置信区间（CI）=1.112-28.482；p=0.037）。
本研究中确定的风险因素可用于为结直肠手术患者创建特定的切口SSI风险分层指数。这种特定的风险分层指数将是预测和比较外科医生和机构之间SSI率的更有效工具。
