Agodi A, Auxilia F, Barchitta M, Cristina M L, D'Alessandro D, Mura I, Nobile M, Pasquarella C, Gisio-SItI Gisio
Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
Ann Ig. 2017 Sep-Oct;29(5):422-430. doi: 10.7416/ai.2017.2174.
Surgical Site Infection (SSI) is one of the major complications following insertion of hip or knee prosthesis. The aim of the present study was to describe rates of SSIs and associated risk factors during hip and knee prosthesis procedures in Italian hospitals.
Italian hospitals were invited to join the ISChIA (Surgical Site Infections in Arthroplasty Surgery) project and participated in the study on a voluntary basis. SSI surveillance was performed according to the Hospitals in Europe Link for Infection Control through Surveillance (HELICS) -SSI protocol. The study population consisted of all patients who had a prosthetic knee or hip joint replacement between March 2010 and February 2011. Only elective operations were include.
A total of 14 hospitals and 1285 surgical procedures were included. SSI cumulative incidence was 1.3 per 100 hip and 2.4 per 100 knee surgical procedures; a significant positive trend of SSI incidences was observed with increasing SSI risk index. In multivariate analysis, considering hip procedures, the single independent risk factor associated to SSI was operation length (RR: 4.54; 95%CI: 1.06-19.48). For knee procedures, no significant risk factor was identified.
In the present study, SSI cumulative incidence was in the range of European data. However, a larger number of operations is needed to better estimate SSI rates. A second edition of the ISChIA project has been already conducted and results of the two surveys will provide new insight to further our knowledge for infection control.
手术部位感染（SSI）是髋关节或膝关节假体植入术后的主要并发症之一。本研究的目的是描述意大利医院髋关节和膝关节假体手术期间的SSI发生率及相关危险因素。
邀请意大利医院加入ISChIA（关节置换手术部位感染）项目，并自愿参与该研究。根据欧洲医院感染控制监测网络（HELICS）-SSI协议进行SSI监测。研究人群包括2010年3月至2011年2月期间进行人工膝关节或髋关节置换的所有患者。仅纳入择期手术。
共纳入14家医院的1285例外科手术。髋关节手术SSI累积发生率为每100例1.3例，膝关节手术为每100例2.4例；随着SSI风险指数增加，观察到SSI发生率呈显著正趋势。多因素分析中，对于髋关节手术，与SSI相关的单一独立危险因素是手术时长（相对风险：4.54；95%置信区间：1.06-19.48）。对于膝关节手术，未识别出显著危险因素。
在本研究中，SSI累积发生率在欧洲数据范围内。然而，需要更多手术病例以更好地估计SSI发生率。ISChIA项目第二版已开展，两项调查结果将为进一步深化我们对感染控制的认识提供新见解。
