中国结直肠手术后手术部位感染的发生率及危险因素：一项全国性横断面研究。
Incidence and risk factors of surgical site infection following colorectal surgery in China: a national cross-sectional study.
机构信息
Research Institute of General Surgery, Jinling Hospital, Nanjing Medical University, Nanjing, 210002, People's Republic of China.
Department of Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China.
出版信息
BMC Infect Dis. 2020 Nov 12;20(1):837. doi: 10.1186/s12879-020-05567-6.
PURPOSES
Surgical site infection (SSI) after colorectal surgery is a frequent complication associated with the increase in morbidity, medical expenses, and mortality. To date, there is no nationwide large-scale database of SSI after colorectal surgery in China. The aim of this study was to determine the incidence of SSI after colorectal surgery in China and to further evaluate the related risk factors.
METHODS
Two multicenter, prospective, cross-sectional studies covering 55 hospitals in China and enrolling adult patients undergoing colorectal surgery were conducted from May 1 to June 30 of 2018 and the same time of 2019. The demographic and perioperative characteristics were collected, and the main outcome was SSI within postoperative 30 days. Multivariable logistic regressions were conducted to predict risk factors of SSI after colorectal surgery.
RESULTS
In total, 1046 patients were enrolled and SSI occurred in 74 patients (7.1%). In the multivariate analysis with adjustments, significant factors associated with SSI were the prior diagnosis of hypertension (OR, 1.903; 95% confidence interval [CI], 1.088-3.327, P = 0.025), national nosocomial infection surveillance risk index score of 2 or 3 (OR, 3.840; 95% CI, 1.926-7.658, P < 0.001), laparoscopic or robotic surgery (OR, 0.363; 95% CI, 0.200-0.659, P < 0.001), and adhesive incise drapes (OR, 0.400; 95% CI, 0.187-0.855, P = 0.018). In addition, SSI group had remarkably increased length of postoperative stays (median, 15.0 d versus 9.0d, P < 0.001), medical expenses (median, 74,620 yuan versus 57,827 yuan, P < 0.001), and the mortality (4.1% versus 0.3%, P = 0.006), compared with those of non-SSI group.
CONCLUSION
This study provides the newest data of SSI after colorectal surgery in China and finds some predictors of SSI. The data presented in our study can be a tool to develop optimal preventive measures and improve surgical quality in China.
目的
结直肠手术后的手术部位感染（SSI）是一种常见的并发症，会增加发病率、医疗费用和死亡率。迄今为止，中国还没有关于结直肠手术后 SSI 的全国性大规模数据库。本研究的目的是确定中国结直肠手术后 SSI 的发生率，并进一步评估相关的危险因素。
方法
2018 年 5 月 1 日至 6 月 30 日和 2019 年同期，进行了两项多中心、前瞻性、横断面研究，涵盖中国的 55 家医院，纳入接受结直肠手术的成年患者。收集人口统计学和围手术期特征，主要结局是术后 30 天内的 SSI。采用多变量逻辑回归预测结直肠手术后 SSI 的危险因素。
结果
共纳入 1046 例患者，74 例（7.1%）发生 SSI。在调整后的多变量分析中，与 SSI 显著相关的因素包括既往高血压诊断（比值比[OR]，1.903；95%置信区间[CI]，1.088-3.327，P=0.025）、国家医院感染监测风险指数评分 2 或 3（OR，3.840；95%CI，1.926-7.658，P<0.001）、腹腔镜或机器人手术（OR，0.363；95%CI，0.200-0.659，P<0.001）和粘性切口盖单（OR，0.400；95%CI，0.187-0.855，P=0.018）。此外，SSI 组的术后住院时间（中位数，15.0 d 与 9.0 d，P<0.001）、医疗费用（中位数，74620 元与 57827 元，P<0.001）和死亡率（4.1%与 0.3%，P=0.006）明显高于非 SSI 组。
结论
本研究提供了中国结直肠手术后 SSI 的最新数据，并发现了一些 SSI 的预测因素。本研究提供的数据可以作为制定最佳预防措施和提高中国手术质量的工具。
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