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1772例腰椎间盘突出症手术患者手术部位感染的危险因素：一项基于多中心观察性登记的研究。

Risk factors for surgical site infections among 1,772 patients operated on for lumbar disc herniation: a multicentre observational registry-based study.

作者信息

Habiba Samer, Nygaard Øystein P, Brox Jens I, Hellum Christian, Austevoll Ivar M, Solberg Tore K

机构信息

Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.

Norwegian Registry for Spine Surgery (NORspine), Northern Norway Regional Health Authority, Bergen, Norway.

出版信息

Acta Neurochir (Wien). 2017 Jun;159(6):1113-1118. doi: 10.1007/s00701-017-3184-2. Epub 2017 Apr 20.

DOI:10.1007/s00701-017-3184-2

PMID:28424918

Abstract

BACKGROUND

There are no previous studies evaluating risk factors for surgical site infections (SSIs) and the effectiveness of prophylactic antibiotic treatment (PAT), specifically for patients operated on for lumbar disc herniation.

METHOD

This observational multicentre study comprises a cohort of 1,772 consecutive patients operated on for lumbar disc herniation without laminectomy or fusion at 23 different surgical units in Norway. The patients were interviewed about SSIs according to a standardised questionnaire at 3 months' follow-up.

RESULTS

Three months after surgery, 2.3% of the patients had an SSI. Only no PAT (OR = 5.3, 95% CI = 2.2-12.7, p< 0.001) and longer duration of surgery than the mean time (68 min) (OR = 2.8, 95% CI = 1.2-6.6, p = 0.02) were identified as independent risk factors for SSI. Numbers needed to have PAT to avoid one SSI was 43.

CONCLUSIONS

In summary, this study clearly lends support to the use of PAT in surgery for lumbar disc herniation. Senior surgeons assisting inexperienced colleagues to avoid prolonged duration of surgery could also reduce the occurrence of SSI.

摘要

背景

既往尚无研究评估手术部位感染（SSI）的危险因素以及预防性抗生素治疗（PAT）的有效性，尤其是针对接受腰椎间盘突出症手术的患者。

方法

这项观察性多中心研究纳入了挪威23个不同手术科室连续接受腰椎间盘突出症手术且未行椎板切除术或融合术的1772例患者。在3个月随访时，根据标准化问卷对患者进行SSI相关访谈。

结果

术后3个月，2.3%的患者发生了SSI。仅未进行PAT（比值比[OR]=5.3，95%置信区间[CI]=2.2-12.7，p<0.001）以及手术时间长于平均时间（68分钟）（OR=2.8，95%CI=1.2-6.6，p=0.02）被确定为SSI的独立危险因素。为避免1例SSI而需要进行PAT的患者数为43。