Cheng Keping, Li Jiawei, Kong Qingfang, Wang Changxian, Ye Nanyuan, Xia Guohua
Department of Infection Control, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu Province, People's Republic of China.
Patient Prefer Adherence. 2015 Aug 14;9:1171-7. doi: 10.2147/PPA.S86153. eCollection 2015.
The purpose of this study was to identify risk factors for surgical site infection (SSI) in a teaching hospital.
A prospective study was initiated to investigate risk factors for SSI at a university-affiliated tertiary care center from July 2013 to December 2014. The chi-square test for categorical variables was used to determine the significance of association, whereas the multivariate logistic regression model was used to examine independent risk factors for SSI.
A total of 1,138 patients met the inclusion criteria, in whom 36 cases of infection occurred during the hospitalization period and two cases occurred after discharge. Univariate analysis showed that SSI was associated with the type of operation, wound classification, volume of blood loss, blood transfusion, American Society of Anesthesiology score before surgery, risk index, duration of surgery, diabetes, cancer, gastrointestinal catheter, urinary catheter, postoperative drainage, and preprocedural white blood cell count. Multivariate analysis identified six independent parameters correlating with the occurrence of SSI: diabetes (odds ratio [OR] 6.400; 95% confidence interval [CI] 2.582-15.866; P=0.000); cancer (OR 2.427; 95% CI 1.028-5.732; P=0.043); preprocedural white blood cell count more than 10×10(9)/L (OR 6.988; CI 3.165-15.425; P=0.000); wound classification (clean contaminated [OR: 7.893; CI: 2.244-27.762; P=0.001]; contaminated [OR: 7.031; CI: 1.652-29.922; P=0.008]; dirty [OR: 48.778; CI: 5.418-439.164; P=0.001]); operative duration more than 120 minutes (OR 4.289; CI 1.773-10.378; P=0.001); and postoperative drainage (OR 3.957; CI 1.422-11.008; P=0.008).
Our data suggest that all these risk factors could be regarded as potential indicators of SSI and that relevant preventive measures should be taken to reduce SSI and improve patient outcomes.
本研究的目的是确定一家教学医院手术部位感染（SSI）的危险因素。
于2013年7月至2014年12月在一所大学附属三级医疗中心开展一项前瞻性研究，以调查SSI的危险因素。分类变量采用卡方检验确定关联的显著性，而多因素逻辑回归模型用于检验SSI的独立危险因素。
共有1138例患者符合纳入标准，其中36例在住院期间发生感染，2例在出院后发生感染。单因素分析显示，SSI与手术类型、伤口分类、失血量、输血、术前美国麻醉医师协会评分、风险指数、手术时长、糖尿病、癌症、胃肠导管、尿管、术后引流及术前白细胞计数有关。多因素分析确定了与SSI发生相关的六个独立参数：糖尿病（比值比[OR]6.400；95%置信区间[CI]2.582 - 15.866；P = 0.000）；癌症（OR 2.427；95% CI 1.028 - 5.732；P = 0.043）；术前白细胞计数超过10×10⁹/L（OR 6.988；CI 3.165 - 15.425；P = 0.000）；伤口分类（清洁 - 污染[OR：7.893；CI：2.244 - 27.762；P = 0.001]；污染[OR：7.031；CI：1.652 - 29.922；P = 0.008]；污秽[OR：48.778；CI：5.418 - 439.164；P = 0.001]）；手术时长超过120分钟（OR 4.289；CI 1.773 - 10.378；P = 0.001）；以及术后引流（OR 3.957；CI 1.422 - 11.008；P = 0.008）。
我们的数据表明，所有这些危险因素都可被视为SSI的潜在指标，应采取相关预防措施以减少SSI并改善患者预后。
