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择期结直肠手术部位感染监测。VINCat 项目(2007-2010 年)的结果。

Surveillance of surgical site infections in elective colorectal surgery. Results of the VINCat Program (2007-2010).

机构信息

Infectious Diseases Service, Hospital Universitario de Bellvitge, Barcelona, Spain.

出版信息

Enferm Infecc Microbiol Clin. 2012 Jun;30 Suppl 3:20-5. doi: 10.1016/S0213-005X(12)70092-7.

Abstract

The VINCat Program is a standardized surveillance program of healthcare infections in Catalonia, Spain. This program includes monitoring of surgical site infections (SSI) of elective colorectal surgery. The aim of this study was to define SSI rates in colorectal surgery among VINCat hospitals over a period of 4 years. We included consecutive elective colorectal interventions performed in VINCat hospitals from 2007 to 2010. Follow-up visits were performed 30 days after surgery. Prospective monitoring of SSI in colorectal surgery was performed according to standardized VINCat methodology. SSI was defined according to the Centers for Disease Control (CDC) and surgical risk factors according to the National Healthcare Safety Network (NHSN) classification. From 2007 to 2010, 49 centers performed 10,104 surgical procedures. The cumulative incidence of SSI was 20.8% (95% CI: 20.03-21.63). The annual cumulative SSI incidence rate did not vary significantly over the study period; however, there were significant differences among hospital infection rates. The relative frequency of organ-space infection increased from 25% in 2007 to 40% in 2010 (p<0.001). Laparoscopic surgery also increased (28% in 2007 to 42% in 2010, p<0.001). However, no changes were observed in mean surgery duration, ASA score and degree of surgical contamination. The VINCat Program incorporated a large number of Catalan hospitals that participated in standardized monitoring of colorectal surgery. The cumulative incidence rate of SSI for colorectal surgery was 20.8%, although there were large variations between hospitals.

摘要

VINCat 计划是西班牙加泰罗尼亚地区针对医疗保健感染的标准化监测计划。该计划包括对择期结直肠手术的手术部位感染(SSI)进行监测。本研究的目的是在 VINCat 医院中确定 4 年来结直肠手术的 SSI 发生率。我们纳入了 2007 年至 2010 年期间在 VINCat 医院进行的连续择期结直肠干预。术后 30 天进行随访。按照标准化的 VINCat 方法对结直肠手术中的 SSI 进行前瞻性监测。SSI 根据疾病控制中心(CDC)的定义,手术危险因素根据国家医疗保健安全网络(NHSN)的分类。2007 年至 2010 年,有 49 个中心进行了 10104 例手术。SSI 的累积发生率为 20.8%(95%CI:20.03-21.63)。研究期间,年度累积 SSI 发生率无显著变化,但医院感染率存在显著差异。器官间隙感染的相对频率从 2007 年的 25%增加到 2010 年的 40%(p<0.001)。腹腔镜手术也有所增加(2007 年为 28%,2010 年为 42%,p<0.001)。然而,手术持续时间、ASA 评分和手术污染程度没有变化。VINCat 计划纳入了许多参与结直肠手术标准化监测的加泰罗尼亚医院。结直肠手术的 SSI 累积发生率为 20.8%,尽管医院之间存在很大差异。

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