Hibbert Denise, Abduljabbar Alaa S, Alhomoud Samar J, Ashari Luai H, Alsanea Nasser
Surg Infect (Larchmt). 2015 Jun;16(3):254-62. doi: 10.1089/sur.2013.208. Epub 2015 Apr 6.
Reported surgical site infection rates range from 2.1% to 40% after colorectal surgery and are believed to be underestimated depending on the method of surveillance. The study aims were to identify an accurate incidence and associated risk factors for abdominal incision surgical site infection after elective open colorectal surgery in a Saudi population.
This was a prospective observational longitudinal study of 300 consecutive adult patients, recruited upon admission to an 800-bed tertiary referral center. All consenting adults admitted for elective open colorectal surgery were included. Patients were followed for 36 d post-surgery by two certified and experienced wound care experts who diagnosed abdominal incision surgical site infections. The definition provided by the U.S. Centers for Disease Control and Prevention was used. Statistical analysis was performed using both univariate and multivariable logistic regression.
Data were analyzed for 296 patients; the incidence of abdominal surgical site infection was 30%. Factors associated with surgical site infection by univariate analysis were pre-operative pre-albumin (p=0.04, odds ratio [OR] 0.81, 95% confidence interval [CI] 0.66-0.99); operative difficulty because of truncal obesity (p=0.006, OR 2.19, 95% CI 1.25-3.84) and obesity measured by body mass index (p=0.002, OR 4.00, 95% CI 1.95-8.20). Multivariable analysis identified only two significant risk factors: Pre-operative pre-albumin (p=0.02, OR 0.76, 95% CI 0.60-0.96), and obesity measured by body mass index (BMI; p=0.001, OR 4.71, 95% CI 2.20-10.10).
Obesity and nutritional status correlated with post-operative abdominal surgical site infection. The method of surveillance and length of follow-up impact the rate reported.
据报道，结直肠手术后手术部位感染率在2.1%至40%之间，并且据信根据监测方法的不同，该感染率被低估了。本研究的目的是确定沙特人群中择期开放性结直肠手术后腹部切口手术部位感染的准确发病率及相关危险因素。
这是一项对300例连续成年患者进行的前瞻性观察性纵向研究，这些患者在一家拥有800张床位的三级转诊中心入院时被招募。所有同意接受择期开放性结直肠手术的成年患者均被纳入。术后由两名经过认证且经验丰富的伤口护理专家对患者进行36天的随访，以诊断腹部切口手术部位感染。采用美国疾病控制与预防中心提供的定义。使用单变量和多变量逻辑回归进行统计分析。
对296例患者的数据进行了分析；腹部手术部位感染的发生率为30%。单变量分析显示，与手术部位感染相关的因素包括术前前白蛋白（p = 0.04，比值比[OR] 0.81，95%置信区间[CI] 0.66 - 0.99）；因躯干肥胖导致的手术难度（p = 0.006，OR 2.19，95% CI 1.25 - 3.84）以及通过体重指数衡量的肥胖（p = 0.002，OR 4.00，95% CI 1.95 - 8.20）。多变量分析仅确定了两个显著的危险因素：术前前白蛋白（p = 0.02，OR 0.76，95% CI 0.60 - 0.96），以及通过体重指数（BMI）衡量的肥胖（p = 0.001，OR 4.71，95% CI 2.20 - 10.10）。
肥胖和营养状况与术后腹部手术部位感染相关。监测方法和随访时间长短会影响报告的感染率。
