He Xiaobo, Li Dongmei, Sun Tingting, Dai Qiaona, Hu Min, Zhu Zhiyong, Sun Xia, Zhou Junjun
Department of Obstetrics,Ningbo Women and Children's Hospital, 315012, Ningbo, Zhejiang, China.
Department of Obstetrics and Gynecology,Feng Hua Maternal Care Centre, 315500, Ningbo, Zhejiang, China.
Ann Med Surg (Lond). 2021 Nov 25;72:103110. doi: 10.1016/j.amsu.2021.103110. eCollection 2021 Dec.
We aimed to determine the prevalence and risk factors of surgical site infection (SSI) after cesarean delivery (CD) in a rural area in China.
We identified 155 patients with incisional and organ/space SSIs by International Classification of Disease codes and matched them with 465 patients (controls) in a time-matched retrospective quality assurance analysis. Multiple logistic regression analyses were performed to examine the risk factors for SSI: the work-years of providers, the number of antenatal care (ANC) visits, CD after labor, positive discharge culture, postoperative C-reactive protein (CRP) levels and fever.
and discussion: During the study, 155 women with SSI were identified among the 8640 patients who delivered by CD. The incidence of SSIs was 179 per 10 000patients (95%CI: 151-207 per 10 000 patients). The total duration of hospitalization in patients with SSI was 14.49 ± 8.68 days compared with 7.96 ± 2.35 days in patients with no SSI (P < 0.01). Multiple logistic regression analysis showed that the work-years of providers (odds ratio [OR] = 3.729, 95% confidence interval [CI]: 1.463-9.501, p = 0.006), irregular ANC visits (OR = 3.245, 95% CI: 1.264-8.329, p = 0.028), CD after labor (OR = 2.545, 95% CI: 0.935-6.926, p = 0.020), postoperative CRP level (OR = 2.545, 95% CI: 0.935-6.926, p = 0.016) and a positive discharge culture (OR = 2.954, 95% CI: 0.305-28.643, p = 0.019) were positively associated with SSI. However, the rates of maternal request (OR = 0.186, 95% CI: 0.065-0.535, p = 0.002) and postoperative fever (OR = 0.208, 95% CI: 0.087-0.494, p = 0.001) were negatively related to SSI.
Special attentions should be paid to CD patients who had irregular ANC visits, attempted labor, a positive discharge culture, higher CRP levels and fever after surgery, who had a greater risk of SSI.
我们旨在确定中国农村地区剖宫产术后手术部位感染（SSI）的患病率及危险因素。
通过国际疾病分类编码识别出155例切口及器官/腔隙SSI患者，并在一项时间匹配的回顾性质量保证分析中将其与465例患者（对照）进行匹配。进行多因素逻辑回归分析以检查SSI的危险因素：医护人员工作年限、产前检查（ANC）次数、分娩后剖宫产、出院时培养阳性、术后C反应蛋白（CRP）水平及发热情况。
在研究期间，8640例剖宫产分娩患者中发现155例SSI患者。SSI发病率为每10000例患者179例（95%置信区间：每10000例患者151 - 207例）。SSI患者的总住院时间为14.49±8.68天，而无SSI患者为7.96±2.35天（P<0.01）。多因素逻辑回归分析显示，医护人员工作年限（比值比[OR]=3.729，95%置信区间[CI]：1.463 - 9.501，p = 0.006）、不规律的ANC检查（OR = 3.245，95% CI：1.264 - 8.329，p = 0.028）、分娩后剖宫产（OR = 2.545，95% CI：0.
