Cvijanovic Vlado S, Ristanović Aleksandar S, Maric Nebojsa T, Vesovic Natasa V, Kostovski Vanja V, Djenic Ljubinko V, Stojkovic Dejan V, Nikolic Aleksandar S, Djordevic Dragan M, Suljagic Vesna D
Clinic for cardiothoracic surgery, Military Medical Academy, Belgrade, Serbia.
J Infect Dev Ctries. 2019 Mar 31;13(3):212-218. doi: 10.3855/jidc.11240.
Surgical site infections (SSI) continue to be a major problem for thoracic surgery patients. We aimed to determine incidence rate (IR) and risk factors for SSI in patients with thoracic surgical procedures.
During 12 years of hospital surveillance of patients with thoracic surgical procedures, we prospectively identified SSI. Patients with SSI were compared with patients without SSI.
We operated 3,370 patients and 205 (6.1%) developed SSI postoperatively. We detected 190 SSI among open thoracic surgical procedures (IR 7.1%) and 15 SSI after video-assisted thoracic surgery (IR 2.1%). Five independent risk factors for SSI were identified: wound contamination (p = 0.013; relative risk (RR) 2.496; 95%, confidence interval (CI): 1.208-5.156), American Society of Anesthesiologist (ASA) score (p = 0.012; RR: 1.795; 95% CI: 1.136-2.834), duration of drainage (p < 0.001; RR: 1.117; 95% CI: 1.085-1.150), age (p = 0.036; RR: 1.018; 95% CI: 1.001-1.035) and duration of operation (p < 0.001; RR:1.005; 95% CI:1.002-1.008).
The results are valuable in documenting risk factors for SSI in patients undergoing thoracic surgery. The knowledge and prevention of controllable risk factors is necessary in order to reduce the incidence of SSI.
手术部位感染（SSI）仍是胸外科患者面临的一个主要问题。我们旨在确定胸外科手术患者SSI的发病率（IR）及危险因素。
在对胸外科手术患者进行为期12年的医院监测期间，我们前瞻性地识别出SSI。将发生SSI的患者与未发生SSI的患者进行比较。
我们对3370例患者进行了手术，其中205例（6.1%）术后发生SSI。我们在开胸手术中检测到190例SSI（IR 7.1%），在电视辅助胸腔镜手术后检测到15例SSI（IR 2.1%）。确定了SSI的五个独立危险因素：伤口污染（p = 0.013；相对危险度（RR）2.496；95%置信区间（CI）：1.208 - 5.156）、美国麻醉医师协会（ASA）评分（p = 0.012；RR：1.795；95% CI：1.136 - 2.834）、引流时间（p < 0.001；RR：1.117；95% CI：1.085 - 1.150）、年龄（p = 0.036；RR：1.018；95% CI：1.001 - 1.035）和手术时间（p < 0.001；RR：1.005；95% CI：1.002 - 1.008）。
这些结果对于记录胸外科手术患者SSI的危险因素具有重要价值。了解并预防可控危险因素对于降低SSI的发生率是必要的。
