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胆囊切除术的手术部位感染率:西班牙马德里地区一家大学教学医院与美国感染率的比较。

Rates of Surgical Site Infection in Cholecystectomy: Comparison between a University Teaching Hospital, Madrid Region, Spain, and USA Rates.

作者信息

Rodríguez-Caravaca Gil, Gil-Yonte Pablo, Del-Moral-Luque Juan Antonio, Lucas Warren Covelé, Fernández-Cebrián José María, Durán-Poveda Manuel

机构信息

Department of Preventive Medicine and Public Health, Hospital Universitario Fundación Alcorcón, Spain.

Department of Medicine, Surgery, Preventive Medicine and Public Health, Universidad Rey Juan Carlos, Spain.

出版信息

Rev Invest Clin. 2017 Nov-Dec;69(6):336-343. doi: 10.24875/RIC.17002197.

Abstract

BACKGROUND

There are many factors that can influence surgical site infections (SSI) in cholecystectomies. Incidence of cholecystectomy SSI was studied and compared with the incidence in Madrid Region, Spain, and the United States.

METHODS

A prospective cohort study was conducted which included all patients who underwent gallbladder surgery for 5 consecutive years, at the Alcorcón Foundation University Teaching Hospital. SSI incidence rate was calculated. An association between risk factors and SSI incidence was assessed with the relative risk (RR). Infection rates were compared to those in the Madrid Region and to the overall Spanish and United States rates using the standardized infection ratio (SIR).

RESULTS

The study included 1532 patients. Cumulative overall SSI was 1.96% (95% confidence interval [CI]: 1.3-2.7). The SIR was 0.89 with respect to the Madrid Region, 0.77 with respect to Spain's rate, and 1.77 with respect to the United States' rate. A laparoscopic route protected against infection (RR = 0.43; 95% CI: 0.2-0.9). Razor shaving in surgical preparation, duration of surgery, and neoplasm increased SSI incidence.

CONCLUSIONS

SSI incidence rates among cholecystectomized patients at our hospital are higher than rates in the United States. A laparoscopic route protected against SSI.

摘要

背景

有许多因素可影响胆囊切除术的手术部位感染(SSI)。对胆囊切除术SSI的发生率进行了研究,并与西班牙马德里地区及美国的发生率进行了比较。

方法

进行了一项前瞻性队列研究,纳入了阿尔科孔基金会大学教学医院连续5年接受胆囊手术的所有患者。计算了SSI发生率。采用相对危险度(RR)评估危险因素与SSI发生率之间的关联。使用标准化感染比值(SIR)将感染率与马德里地区以及西班牙和美国的总体感染率进行比较。

结果

该研究纳入了1532例患者。累积总体SSI为1.96%(95%置信区间[CI]:1.3 - 2.7)。相对于马德里地区,SIR为0.89;相对于西班牙的发生率,SIR为0.77;相对于美国的发生率,SIR为1.77。腹腔镜手术方式可预防感染(RR = 0.43;95% CI:0.2 - 0.9)。手术准备中剃毛、手术时间以及肿瘤会增加SSI发生率。

结论

我院胆囊切除患者的SSI发生率高于美国。腹腔镜手术方式可预防SSI。

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