Department of Orthopaedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
Br J Neurosurg. 2023 Jun;37(3):254-257. doi: 10.1080/02688697.2020.1769552. Epub 2020 Jun 1.
Data about postoperative infections in male adults with spinal cord injury are scarce. We aimed to evaluate the association between prior exposure to pressure ulcers (PU) and the risk of postoperative infections in male adults with spinal cord injury (SCI).
We conducted a prospective study of male adults receiving surgery of SCI from January 2007 to December 2019. Postoperative infection included septicemia, pneumonia, surgical incision infection and urinary tract infection. A logistic regression analysis was applied. Risk ratios (RRs) and their corresponding 95% confidence intervals (CIs) were calculated.
There were 408 patients with SCI in this study, which comprised 204 patients with prior PU and 204 patients without. The rate of postoperative infections within 14 days in patients with PU was 23.5%, which was higher than that of patients without PU (6.9%). The amounts to a 4.18-folds elevated risk of any postoperative infections with 14 days in patients with PU (RR: 4.18, 95% CI: 2.30-7.60, -value: <0.001). With respect to specific infections, positive associations in pneumonia (RR: 4.18, 95% CI: 2.30-7.60, -value: <0.001), surgical incision infection (RR: 4.18, 95% CI: 2.30-7.60, -value: <0.001), and urinary tract infection (RR: 4.18, 95% CI: 2.30-7.60, -value: <0.001) were also statistically significant. These results did not materially alter adjustment for potential risk factors.
The study suggests an elevated risk of postoperative infections after surgery for SCI in male patients with prior exposure to pressure ulcers.
有关脊髓损伤成年男性术后感染的数据较为匮乏。我们旨在评估男性脊髓损伤（SCI）患者既往发生压疮（PU）与术后感染风险的相关性。
我们开展了一项前瞻性研究，纳入 2007 年 1 月至 2019 年 12 月期间接受 SCI 手术的成年男性患者。术后感染包括败血症、肺炎、手术切口感染和尿路感染。采用 logistic 回归分析。计算风险比（RR）及其 95%置信区间（CI）。
本研究共纳入 408 例 SCI 患者，其中 204 例患者既往有 PU，204 例患者无 PU。PU 患者术后 14 天内感染率为 23.5%，高于无 PU 患者（6.9%）。这意味着 PU 患者术后 14 天内发生任何感染的风险增加了 4.18 倍（RR：4.18，95%CI：2.30-7.60，-值：<0.001）。具体感染方面，肺炎（RR：4.18，95%CI：2.30-7.60，-值：<0.001）、手术切口感染（RR：4.18，95%CI：2.30-7.60，-值：<0.001）和尿路感染（RR：4.18，95%CI：2.30-7.60，-值：<0.001）的相关性也具有统计学意义。这些结果在调整潜在风险因素后并没有实质性改变。
该研究表明，既往发生过压疮的男性 SCI 患者术后发生感染的风险增加。
