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颅内动脉瘤术后患者医院感染影响因素分析。

Analysis of factors influencing hospital-acquired infection in postoperative patients with intracranial aneurysm.

机构信息

Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China International Neuroscience Institute (China-INI), 45 Changchun Street, Beijing, 100053, China.

Hospital Infection Management Division, Xuanwu Hospital, Capital Medical University, Beijing, China.

出版信息

BMC Neurol. 2019 Dec 20;19(1):332. doi: 10.1186/s12883-019-1565-2.

Abstract

BACKGROUND

Hospital-acquired infection (HAI) is a serious complication of neurosurgery. In recent years, the medical body has paid increasing attention to this issue.

AIM

We investigated the status of HAIs in patients who had undergone surgery for intracranial aneurysms and analysed their risk factors.

METHODS

A retrospective analysis was carried out on the medical records of 542 patients with intracranial aneurysms after they were admitted for neurosurgery at Xuanwu Hospital of Capital Medical University between January and December 2016. Cases studied were divided into an infection group and a control group. Logistic regression analysis of the data was carried out.

FINDINGS

Of the 542 patients with intracranial aneurysms who underwent surgery, 77 HAIs occurred in 64 patients, with an infection prevalence of 11.8% and prevalence of infection cases of 14.2%. Logistic regression showed that an admission Glasgow Coma Scale (GCS) score of less than 8 points (odds ratio = 4.261, 95% confidence interval 1.102-16.476), hyperglycaemia (2.759, 1.159-6.564), hypothermia treatment (6.557, 2.244-19.159), and central venous catheterisation (CVC) (8.853, 2.860-27.398) were independent risk factors for HAIs in patients with intracranial aneurysm who underwent surgery.

CONCLUSION

Being comatose upon hospital admission, having hyperglycaemia or hypothermia, and indwelling CVC are major risk factors for HAIs in patients undergoing surgery for intracranial aneurysms.

摘要

背景

医院获得性感染(HAI)是神经外科的严重并发症。近年来,医学界越来越关注这一问题。

目的

我们调查了颅内动脉瘤手术患者的 HAI 现状,并分析了其危险因素。

方法

对 2016 年 1 月至 12 月首都医科大学宣武医院神经外科收治的 542 例颅内动脉瘤患者的病历进行回顾性分析。将患者分为感染组和对照组。对数据进行 logistic 回归分析。

结果

542 例颅内动脉瘤手术患者中,64 例发生 77 例 HAI,感染率为 11.8%,感染例数占比为 14.2%。logistic 回归分析显示,入院格拉斯哥昏迷量表(GCS)评分<8 分(比值比=4.261,95%置信区间 1.102-16.476)、高血糖(2.759,1.159-6.564)、低温治疗(6.557,2.244-19.159)和中心静脉置管(CVC)(8.853,2.860-27.398)是颅内动脉瘤手术患者 HAI 的独立危险因素。

结论

入院时昏迷、高血糖或低体温以及留置 CVC 是颅内动脉瘤手术患者发生 HAI 的主要危险因素。

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