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术前住院时间:股骨骨折病例中降低手术感染的一个风险因素。

Length of preoperative hospital stay: a risk factor for reducing surgical infection in femoral fracture cases.

作者信息

Pereira Hoberdan Oliveira, Rezende Edna Maria, Couto Bráulio Roberto Gonçalves Marinho

机构信息

Department of Nursing, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Institute of Engineering and Technology, University Center of Belo Horizonte (UNIBH), Belo Horizonte, MG, Brazil.

出版信息

Rev Bras Ortop. 2015 Oct 23;50(6):638-46. doi: 10.1016/j.rboe.2015.09.006. eCollection 2015 Nov-Dec.

Abstract

OBJECTIVE

To analyze infections of the surgical site among patients undergoing clean-wound surgery for correction of femoral fractures.

METHODS

This was a historical cohort study developed in a large-sized hospital in Belo Horizonte. Data covering the period from July 2007 to July 2009 were gathered from the records in electronic medical files, relating to the characteristics of the patients, surgical procedures and surgical infections. The risk factors for infection were identified by means of statistical tests on bilateral hypotheses, taking the significance level to be 5%. Continuous variables were evaluated using Student's t test. Categorical variables were evaluated using the chi-square test, or Fisher's exact test, when necessary. For each factor under analysis, a point estimate and the 95% confidence interval for the relative risk were obtained. In the final stage of the study, multivariate logistic regression analysis was performed.

RESULTS

432 patients who underwent clean-wound surgery for correcting femoral fractures were included in this study. The rate of incidence of surgical site infections was 4.9% and the risk factors identified were the presence of stroke (odds ratio, OR = 5.0) and length of preoperative hospital stay greater than four days (OR = 3.3).

CONCLUSION

To prevent surgical site infections in operations for treating femoral fractures, measures involving assessment of patients' clinical conditions by a multiprofessional team, reduction of the length of preoperative hospital stay and prevention of complications resulting from infections will be necessary.

摘要

目的

分析接受股骨骨折清创手术患者的手术部位感染情况。

方法

这是一项在贝洛奥里藏特一家大型医院开展的历史性队列研究。收集了2007年7月至2009年7月期间电子病历记录中的数据,内容涉及患者特征、手术操作及手术感染情况。通过双侧假设的统计检验确定感染的危险因素,显著性水平设定为5%。连续变量采用学生t检验进行评估。分类变量必要时采用卡方检验或费舍尔精确检验进行评估。对于每个分析因素,获得相对风险的点估计值和95%置信区间。在研究的最后阶段,进行多因素逻辑回归分析。

结果

本研究纳入了432例行股骨骨折清创手术的患者。手术部位感染发生率为4.9%,确定的危险因素为中风(比值比,OR = 5.0)和术前住院时间超过4天(OR = 3.3)。

结论

为预防股骨骨折手术中的手术部位感染,多专业团队评估患者临床状况、缩短术前住院时间以及预防感染相关并发症的措施是必要的。

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