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血管外科手术后伤口感染的危险因素:科威特的经验

Risk Factors for Wound Infections after Vascular Surgery: Kuwait Experience.

作者信息

AlFawaz Abdullah A, Safar Ali H, Al-Mukhaizeem Ali, Kamal Emad, Alloush Mohammed, Hanbal Ebrahim

机构信息

Department of Surgery, Faculty of Medicine, Kuwait University Health Sciences Centre, Jabriya, Kuwait.

Department of Surgery, Vascular Unit, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait.

出版信息

Med Princ Pract. 2022;31(4):392-398. doi: 10.1159/000525158. Epub 2022 May 19.

Abstract

INTRODUCTION

Wound infections represent a serious complication after vascular surgery particularly after vascular reconstructive procedures. We aimed to identify risk factors predisposing patients to these complications.

METHODS

This was a retrospective review of open vascular surgical procedures performed between April 2014 and March 2019 in Kuwait. Patient demographics, procedures performed and their indications, and post-operative outcomes were collected and analyzed. Patients with pre-operative active infections were excluded from the analysis. Statistical analysis was performed, and odds ratios (ORs) and relative risks were calculated for the outcomes of interest. Fisher's exact test and two-tailed t test were used where appropriate.

RESULTS

391 patients were identified. The majority (54%) presented with chronic limb threatening ischemia. The mean age was 58 (±10) years, with a male predominance (76%). Wound infection occurred in 53 (14%) patients. The most commonly isolated organism was Staphylococcus aureus (47%). Diabetes (OR 8.03, 95% CI: 1.9142-33.7439, p = 0.0044), hypertension (OR 2.38, 95% CI: 1.2960-4.3684, p = 0.0052), ischemic heart disease (OR 2.30, 95% CI: 1.4349-4.6987, p = 0.0016), hyperlipidemia (OR 2.12, 95% CI: 1.0305-4.3620, p = 0.0412), and chronic renal failure (OR 2.55, 95% CI: 1.0181-6.4115, p = 0.0457) were all found to be significantly associated with the development of post-operative wound infections in vascular surgery patients.

CONCLUSION

Diabetes, hypertension, ischemic heart disease, hyperlipidemia, and chronic renal failure were associated with post-operative wound infections. Anticipation of wound complications in patients with these risk factors may aid early diagnosis and treatment.

摘要

引言

伤口感染是血管手术后的一种严重并发症,尤其是在血管重建手术后。我们旨在确定易使患者发生这些并发症的危险因素。

方法

这是一项对2014年4月至2019年3月在科威特进行的开放性血管外科手术的回顾性研究。收集并分析了患者的人口统计学资料、所施行的手术及其指征以及术后结果。术前有活动性感染的患者被排除在分析之外。进行了统计分析,并计算了感兴趣结局的比值比(OR)和相对风险。在适当情况下使用了Fisher精确检验和双尾t检验。

结果

共确定了391例患者。大多数(54%)表现为慢性肢体威胁性缺血。平均年龄为58(±10)岁,男性占多数(76%)。53例(14%)患者发生了伤口感染。最常分离出的病原体是金黄色葡萄球菌(47%)。糖尿病(OR 8.03,95%可信区间:1.9142 - 33.7439,p = 0.0044)、高血压(OR 2.38,95%可信区间:1.2960 - 4.3684,p = 0.0052)、缺血性心脏病(OR 2.30,95%可信区间:1.4349 - 4.6987,p = 0.0016)、高脂血症(OR 2.12,95%可信区间:1.0305 - 4.3620,p = 0.0412)和慢性肾衰竭(OR 2.55,95%可信区间:1.0181 - 6.4115,p = 0.0457)均被发现与血管外科手术患者术后伤口感染的发生显著相关。

结论

糖尿病、高血压、缺血性心脏病、高脂血症和慢性肾衰竭与术后伤口感染有关。对具有这些危险因素的患者的伤口并发症进行预判可能有助于早期诊断和治疗。

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The Socioeconomic Impact of Surgical Site Infections.手术部位感染的社会经济影响。
Front Public Health. 2021 Aug 4;9:712461. doi: 10.3389/fpubh.2021.712461. eCollection 2021.

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