Division of Rhinology and Skull Base Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Epidemiology and Population Health (Biostatistics), Albert Einstein College of Medicine, Bronx NY, USA.
Ann Otol Rhinol Laryngol. 2022 Jan;131(1):5-11. doi: 10.1177/00034894211007240. Epub 2021 Apr 9.
There is a paucity of data on postoperative infections after endoscopic sinus surgery and associated risk factors. Our objective was to evaluate a cohort of patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis to determine which perioperative factors may be associated with infection in the 30-day postoperative period.
A retrospective cohort study of adults who underwent ESS at a tertiary academic medical center from 2015 to 2018 was performed. The primary outcome was incidence of postoperative infection, defined by identification of sinus purulence on nasal endoscopy necessitating antibiotics within 30 days of surgery. Independent variables collated included the result of postoperative cultures and use of perioperative antibiotics, oral corticosteroids, packing, and steroid-eluting stents. Statistical analysis involved bivariate analysis to identify variables that correlated with postoperative infection and subsequent multivariate logistic regression to identify independent risk factors.
Three hundred seventy-eight unique ESS cases performed in 356 patients were reviewed. The mean age was 46 years (range, 18-87). The most common indication for surgery was chronic rhinosinusitis without nasal polyposis. The postoperative infection rate was 10.1%. The most commonly cultured pathogen was Multivariate logistic regression analysis showed that postoperative systemic corticosteroid use was the only risk factor independently associated with infection (OR 3.47 [95% CI 1.23-9.76], = .018).
The incidence of postoperative infection following ESS was 10.1%. The use of postoperative systemic corticosteroids independently increased the risk of infection by 3.47-fold.
内镜鼻窦手术后感染及其相关危险因素的数据较少。我们的目的是评估一组接受内镜鼻窦手术（ESS）治疗慢性鼻-鼻窦炎的患者，以确定哪些围手术期因素可能与术后 30 天内的感染相关。
对 2015 年至 2018 年在一家三级学术医疗中心接受 ESS 的成年人进行回顾性队列研究。主要结局是术后感染的发生率，通过鼻内镜检查发现窦道脓液，术后 30 天内需要使用抗生素来定义。收集的独立变量包括术后培养结果以及围手术期使用抗生素、口服皮质类固醇、填塞和类固醇洗脱支架的情况。统计分析包括双变量分析以确定与术后感染相关的变量，以及随后的多变量逻辑回归分析以确定独立的危险因素。
共回顾了 356 例患者的 378 例 ESS 手术。平均年龄为 46 岁（范围 18-87 岁）。最常见的手术指征是慢性鼻-鼻窦炎，不伴鼻息肉。术后感染率为 10.1%。最常见的培养病原体是 Multivariate logistic regression analysis showed that postoperative systemic corticosteroid use was the only risk factor independently associated with infection (OR 3.47 [95% CI 1.23-9.76], = .018).
ESS 后感染的发生率为 10.1%。术后使用全身皮质类固醇会使感染的风险独立增加 3.47 倍。
