Choi H J, Adiyani L, Sung J, Choi J Y, Kim H B, Kim Y K, Kwak Y G, Yoo H, Lee Sang-Oh, Han S H, Kim S R, Kim T H, Lee H M, Chun H K, Kim J-S, Yoo J D, Koo H-S, Cho E H, Lee K W
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South Korea.
Department of Epidemiology and Institute of Environment and Health, Seoul National University, Seoul, South Korea.
J Hosp Infect. 2016 Aug;93(4):339-46. doi: 10.1016/j.jhin.2015.12.021. Epub 2016 Jan 30.
Surveillance of healthcare-associated infection has been associated with a reduction in surgical site infection (SSI).
To evaluate the Korean Nosocomial Infection Surveillance System (KONIS) in order to assess its effects on SSI since it was introduced.
SSI data after gastrectomy, total hip arthroplasty (THA), and total knee arthroplasty (TKA) between 2008 and 2012 were analysed. The pooled incidence of SSI was calculated for each year; the same analyses were also conducted from hospitals that had participated in KONIS for at least three consecutive years. Standardized SSI rates for each year were calculated by adjusting for SSI risk factors. SSI trends were analysed using the Cochran-Armitage test.
The SSI rate following gastrectomy was 3.12% (522/16,918). There was a significant trend of decreased crude SSI rates over five years. This trend was also evident in analysis of hospitals that had participated for more than three years. The SSI rate for THA was 2.05% (157/7656), which decreased significantly from 2008 to 2012. The risk factors for SSI after THA included the National Nosocomial Infections Surveillance risk index, trauma, reoperation, and age (60-69 years). The SSI rate for TKA was 1.90% (152/7648), which also decreased significantly during a period of five years. However, the risk-adjusted analysis of SSI did not show a significant decrease for all surgical procedures.
The SSI incidence of gastrectomy and prosthetic joint replacement declined over five years as a result of active surveillance by KONIS.
医疗保健相关感染监测与手术部位感染（SSI）的减少有关。
评估韩国医院感染监测系统（KONIS），以评估自其引入以来对SSI的影响。
分析了2008年至2012年胃切除术、全髋关节置换术（THA）和全膝关节置换术（TKA）后的SSI数据。计算每年SSI的合并发病率；对连续至少参加KONIS三年的医院也进行了同样的分析。通过调整SSI危险因素计算每年的标准化SSI率。使用 Cochr an-Armitage检验分析SSI趋势。
胃切除术后的SSI率为3.12%（522/16918）。五年间粗SSI率有显著下降趋势。在对参加超过三年的医院的分析中，这一趋势也很明显。THA的SSI率为2.05%（157/7656），从2008年到2012年显著下降。THA后SSI的危险因素包括国家医院感染监测风险指数、创伤、再次手术和年龄（60 - 69岁）。TKA的SSI率为1.90%（152/7648），在五年期间也显著下降。然而，SSI的风险调整分析并未显示所有手术程序都有显著下降。
由于KONIS的积极监测，胃切除术和人工关节置换术的SSI发病率在五年间有所下降。
