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直肠手术中手术部位感染的发生率及危险因素:一项前瞻性队列研究。

Incidence of surgical site infection and risk factors in rectal surgery: A prospective cohort study.

作者信息

Colás-Ruiz Enrique, Del-Moral-Luque Juan Antonio, Gil-Yonte Pablo, Fernández-Cebrián José María, Alonso-García Marcos, Villar-Del-Campo María Concepción, Durán-Poveda Manuel, Rodríguez-Caravaca Gil

机构信息

Unidad de Cirugía General, Hospital Universitario Fundación Alcorcón, Madrid, España; Escuela Intenacional de Doctorado, Universidad Rey Juan Carlos, Madrid, España.

Unidad de Medicina Preventiva y Salud Pública, Hospital Universitario Fundación Alcorcón, Madrid, España; Escuela Intenacional de Doctorado, Universidad Rey Juan Carlos, Madrid, España.

出版信息

Cir Esp (Engl Ed). 2018 Dec;96(10):640-647. doi: 10.1016/j.ciresp.2018.06.007. Epub 2018 Aug 6.

Abstract

INTRODUCTION

Surgical site infection (SSI) is the main cause of nosocomial infection in Spain. The aim of this study was to analyze the incidence of SSI and to evaluate its risk factors in patients undergoing rectal surgery.

METHODS

Prospective cohort study, conducted from January 2013 to December 2016. Patient, surgical intervention and infection variables were collected. Infection rate was calculated after a maximum period of 30 days of incubation. The effect of different risk factors on infection was assessed using the odds ratio adjusted by a logistic regression model.

RESULTS

The study included 154 patients, with a mean age of 69.5±12 years. The most common comorbidities were diabetes mellitus (24.5%), chronic obstructive pulmonary disease (17%) and obesity (12.6%). The overall incidence of SSI during the follow-up period was 11.9% (CI95%: 7.8-17.9) and the most frequent microorganism was Escherichia coli (57.9%). Risk factors associated with surgical wound infection in the univariate analysis were blood transfusion, drain tubes and vasoactive drug administration (P<.05).

CONCLUSIONS

The incidence of SSI in rectal surgery was low. It is crucial to assess SSI incidence rates and to identify possible risk factors for infection. We recommend implementing surveillance and hospital control programs.

摘要

引言

手术部位感染(SSI)是西班牙医院感染的主要原因。本研究的目的是分析直肠手术患者中SSI的发生率,并评估其危险因素。

方法

前瞻性队列研究,于2013年1月至2016年12月进行。收集患者、手术干预和感染变量。在最长30天的潜伏期后计算感染率。使用逻辑回归模型调整的优势比评估不同危险因素对感染的影响。

结果

该研究纳入了154例患者,平均年龄为69.5±12岁。最常见的合并症为糖尿病(24.5%)、慢性阻塞性肺疾病(17%)和肥胖(12.6%)。随访期间SSI的总体发生率为11.9%(95%CI:7.8-17.9),最常见的微生物是大肠杆菌(57.9%)。单因素分析中与手术伤口感染相关的危险因素为输血、引流管和血管活性药物的使用(P<0.05)。

结论

直肠手术中SSI的发生率较低。评估SSI发生率并识别可能的感染危险因素至关重要。我们建议实施监测和医院控制计划。

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