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心血管手术后手术部位感染的发生率和结局(全文转载)。

Incidence and outcomes of surgical site infection after cardiovascular surgery (complete republication).

机构信息

Division of Cardiovascular Surgery, Department of General Surgical Science, Gunma University, Showa-machi 3-39-22, Maebashi, Gunma, Japan.

Division of Cardiovascular Surgery, Japan Society for Surgical Infection, Tokyo, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2022 Dec;70(12):1009-1014. doi: 10.1007/s11748-022-01850-2. Epub 2022 Jul 9.

Abstract

OBJECTIVES

Surgical site infection in cardiovascular surgery had a great effect on postoperative outcomes. This study examined the current status of surgical site infection and postoperative outcomes used the registered data of the Japan Cardiovascular Surgery Database.

METHODS

From the registry, we extracted 53,186 cases of thoracic cardiovascular surgery performed under median sternotomy in 2018. According to Japanese Healthcare Associated Infections Surveillance (JHAIS), patients were divided into three groups: coronary artery bypass graft (CABG) with saphenous vein graft (SVG) (SVG+ ; n = 14,246), CABG without SVG (SVG-; n = 5535), and operations other than CABG (no CABG; n = 33,405). The incidence of deep sternal wound infection, leg wound infection, hospital death, and hospitalization more than 90 days was examined.

RESULTS

The incidence of deep sternal wound infection is 1.4% in all cases and 1.7% in SVG+ , 1.2% in SVG-, and 1.4% in no CABG. In deep sternal wound infection cases, incidence of hospital death was 24.7% and was higher than no infection cases. Especially, in no CABG group, incidence of hospital death was 30.1%. The long-term hospitalization rate and readmission rate within 30 days of patients with deep sternal wound infection were also high.

CONCLUSIONS

The incidence of deep sternal wound infection was low, but it has not decreased. Postoperative outcomes in patients with surgical site infection were still bad.

摘要

目的

心血管手术后的手术部位感染对术后结果有很大影响。本研究使用日本心血管手术数据库的注册数据检查了手术部位感染和术后结果的现状。

方法

我们从该注册处提取了 2018 年正中胸骨切开术下进行的 53186 例胸心血管手术。根据日本医疗保健相关感染监测(JHAIS),患者分为三组:冠状动脉旁路移植术(CABG)伴大隐静脉移植物(SVG)(SVG+;n=14246)、无 SVG 的 CABG(SVG-;n=5535)和非 CABG 手术(无 CABG;n=33405)。检查了深部胸骨伤口感染、腿部伤口感染、住院死亡和住院时间超过 90 天的发生率。

结果

所有病例深部胸骨伤口感染的发生率为 1.4%,SVG+为 1.7%,SVG-为 1.2%,无 CABG 为 1.4%。在深部胸骨伤口感染病例中,住院死亡的发生率为 24.7%,高于无感染病例。特别是在无 CABG 组,住院死亡的发生率为 30.1%。深部胸骨伤口感染患者的长期住院率和 30 天内再入院率也较高。

结论

深部胸骨伤口感染的发生率虽然较低,但并未降低。手术部位感染患者的术后结果仍然较差。

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