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血管显露后腹股沟伤口感染(GIVE)多中心队列研究。

Groin wound infection after vascular exposure (GIVE) multicentre cohort study.

机构信息

Vascular and Endovascular Research Network (VERN), UK.

出版信息

Int Wound J. 2021 Apr;18(2):164-175. doi: 10.1111/iwj.13508. Epub 2020 Nov 25.

Abstract

Surgical site infections (SSIs) of groin wounds are a common and potentially preventable cause of morbidity, mortality, and healthcare costs in vascular surgery. Our aim was to define the contemporaneous rate of groin SSIs, determine clinical sequelae, and identify risk factors for SSI. An international multicentre prospective observational cohort study of consecutive patients undergoing groin incision for femoral vessel access in vascular surgery was undertaken over 3 months, follow-up was 90 days. The primary outcome was the incidence of groin wound SSI. 1337 groin incisions (1039 patients) from 37 centres were included. 115 groin incisions (8.6%) developed SSI, of which 62 (4.6%) were superficial. Patients who developed an SSI had a significantly longer length of hospital stay (6 versus 5 days, P = .005), a significantly higher rate of post-operative acute kidney injury (19.6% versus 11.7%, P = .018), with no significant difference in 90-day mortality. Female sex, Body mass index≥30 kg/m , ischaemic heart disease, aqueous betadine skin preparation, bypass/patch use (vein, xenograft, or prosthetic), and increased operative time were independent predictors of SSI. Groin infections, which are clinically apparent to the treating vascular unit, are frequent and their development carries significant clinical sequelae. Risk factors include modifiable and non-modifiable variables.

摘要

腹股沟伤口的外科部位感染(SSI)是血管外科中发病率、死亡率和医疗保健成本的常见且潜在可预防的原因。我们的目的是定义腹股沟 SSI 的当代发生率,确定临床后果,并确定 SSI 的危险因素。对 3 个月内连续进行股血管通路腹股沟切开术的患者进行了一项国际多中心前瞻性观察队列研究,随访时间为 90 天。主要结局是腹股沟伤口 SSI 的发生率。来自 37 个中心的 1337 个腹股沟切口(1039 例患者)被纳入研究。115 个腹股沟切口(8.6%)发生了 SSI,其中 62 个(4.6%)为浅表性 SSI。发生 SSI 的患者的住院时间明显延长(6 天与 5 天,P =.005),术后急性肾损伤的发生率明显更高(19.6%与 11.7%,P =.018),90 天死亡率无显著差异。女性、体重指数≥30 kg/m²、缺血性心脏病、水性聚维酮碘皮肤准备、旁路/补片使用(静脉、异种移植物或假体)以及手术时间延长是 SSI 的独立预测因素。腹股沟感染是血管治疗单位明显的临床症状,较为常见,其发展会带来显著的临床后果。危险因素包括可改变和不可改变的变量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ae5/8244001/f233b42fd971/IWJ-18-164-g003.jpg

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