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原创文章——三级医疗中心儿科心脏手术后的手术部位感染:发生率及危险因素

Original Article--Surgical site infections following pediatric cardiac surgery in a tertiary care hospital: Rate and risk factors.

作者信息

Alshaya Milad A, Almutairi Nouf S, Shaath Ghassan A, Aldosari Rahmah A, Alnami Sadeem K, Althubaiti Alaa, Abu-Sulaiman Riyadh M

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Department of Cardiac Sciences, King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.

出版信息

J Saudi Heart Assoc. 2021 Apr 15;33(1):1-8. doi: 10.37616/2212-5043.1234. eCollection 2021.

Abstract

BACKGROUND

Surgical site infections [SSIs] are the second most common type of healthcare-associated infections and leading cause of postoperative morbidity and mortality in pediatric cardiac surgery. This study aims to determine the rate of, risk factors for, and most common pathogen associated with the development of SSIs after pediatric cardiac surgery.

METHODS

Patients aged ≤14 years who underwent cardiac surgery at our tertiary care hospital between January 2010 and December 2015 were retrospectively reviewed.

RESULTS

The SSI rate was 7.8% among the 1510 pediatric patients reviewed. Catheter-associated urinary tract infection [CAUTI] [odds ratio [OR] 5.7; 95% confidence interval [CI] 2.3-13.8; P < 0.001], ventilator-associated pneumonia [VAP] [OR 3.2; 95% CI 1.4-7.2; P = 0.005], longer postoperative stay [≥25 days] [OR 4.1; 95% CI 2.1-8.1; P < 0.001], and a risk adjustment in congenital heart surgery [RACHS-1] score of ≥2 [OR 2.4; 95% CI 1.2-5.6; P = 0.034] were identified as risk factors for SSIs. was the most common pathogen [32.2%].

CONCLUSIONS

SSI risk factors were longer postoperative stay, CAUTI, VAP, and RACHS-1 score of ≥2. Identification and confirmation of risk factors in this study is important in order to reduce the rate of SSIs following cardiac surgery.

摘要

背景

手术部位感染(SSIs)是医疗相关感染的第二大常见类型,也是小儿心脏手术术后发病和死亡的主要原因。本研究旨在确定小儿心脏手术后SSIs的发生率、危险因素以及与之相关的最常见病原体。

方法

回顾性分析2010年1月至2015年12月在我院三级医疗中心接受心脏手术的14岁及以下患者。

结果

在1510例接受回顾的儿科患者中,SSI发生率为7.8%。与导尿管相关的尿路感染(CAUTI)(比值比[OR]5.7;95%置信区间[CI]2.3 - 13.8;P < 0.001)、呼吸机相关性肺炎(VAP)(OR 3.2;95%CI 1.4 - 7.2;P = 0.005)、术后住院时间延长(≥25天)(OR 4.1;95%CI 2.1 - 8.1;P < 0.001)以及先天性心脏手术风险调整(RACHS - 1)评分≥2(OR 2.4;95%CI 1.2 - 5.6;P = 0.034)被确定为SSIs的危险因素。 是最常见的病原体(32.2%)。

结论

SSI的危险因素是术后住院时间延长、CAUTI、VAP以及RACHS - 1评分≥2。本研究中危险因素的识别和确认对于降低心脏手术后SSIs的发生率很重要。

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