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预测腹疝修补术后手术部位感染的评分系统的开发与验证:一项密歇根外科质量合作研究

Development and Validation of a Scoring System to Predict Surgical Site Infection After Ventral Hernia Repair: A Michigan Surgical Quality Collaborative Study.

作者信息

Karamanos Efstathios, Kandagatla Pridvi, Watson Jenna, Schmoekel Nathan, Siddiqui Aamir

机构信息

Department of General Surgery and the Department of Plastic and Reconstructive Surgery, Henry Ford Hospital/Wayne State University, 2799 W Grand Blvd, Detroit, MI, 48202, USA.

出版信息

World J Surg. 2017 Apr;41(4):914-918. doi: 10.1007/s00268-016-3835-0.

Abstract

INTRODUCTION

Surgical site infections (SSIs) are a rare but significant complication following an elective ventral hernia repair. This study aims to develop a risk assessment tool in order to predict the risk of developing SSIs postoperatively.

METHODS

All patients undergoing an elective ventral hernia repair were identified using the Michigan Surgical Quality Collaborative (MSQC) database. Patients' demographics, comorbidities and technical aspects of the operations were extracted. Logistic regressions were used to create a predictive scoring system for SSIs.

RESULTS

A total of 4983 were included. SSIs occurred in 3.4% of the patient population. A stepwise forward logistic regression identified the need to use drains, BMI, wound classification at the end of the surgery, presence of severe adhesions, a history of CAD, the need for intensive care after surgery, the use of pressors, EtOH abuse and history of PVD as being independently associated with the development of postoperative surgical site infections.

CONCLUSION

In patients undergoing an elective hernia repair, the incidence of SSI is low. Several preoperative and perioperative factors can contribute to the development of SSIs.

摘要

引言

手术部位感染(SSIs)是择期腹疝修补术后一种罕见但严重的并发症。本研究旨在开发一种风险评估工具,以预测术后发生手术部位感染的风险。

方法

使用密歇根外科质量协作组织(MSQC)数据库识别所有接受择期腹疝修补术的患者。提取患者的人口统计学信息、合并症和手术技术方面的信息。使用逻辑回归创建手术部位感染的预测评分系统。

结果

共纳入4983例患者。3.4%的患者发生了手术部位感染。逐步向前逻辑回归确定,使用引流管、体重指数(BMI)、手术结束时的伤口分类、严重粘连的存在、冠心病史、术后需要重症监护、使用升压药、酒精滥用和外周血管疾病史与术后手术部位感染的发生独立相关。

结论

在接受择期疝修补术的患者中,手术部位感染的发生率较低。几个术前和围手术期因素可导致手术部位感染的发生。

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