性别对腹部手术部位感染无影响：一项多中心研究。
No impact of sex on surgical site infections in abdominal surgery: a multi-center study.
机构信息
Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Institute for Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland.
出版信息
Langenbecks Arch Surg. 2022 Dec;407(8):3763-3769. doi: 10.1007/s00423-022-02691-6. Epub 2022 Oct 10.
OBJECTIVE
Male sex is controversially discussed as a risk factor for surgical site infections (SSI). The aim of the present study was to evaluate the impact of sex on SSI in abdominal surgery under elimination of relevant confounders.
METHODS
Clinicopathological data of 6603 patients undergoing abdominal surgery from a multi-center prospective database of four Swiss hospitals including patients between 2015 and 2018 were assessed. Patients were stratified according to postoperative SSI and risk factors for SSI were identified using univariate and multivariate analysis.
RESULTS
In 649 of 6603 patients, SSI was reported (9.8%). SSI was significantly associated with reoperation (22.7% vs. 3.4%, p < 0.001), increased mortality rate (4.6% vs. 0.9%, p < 0.001), and increased rate of length of hospital stay > 75th percentile (57.0% vs. 17.9%, p < 0.001). In univariate analysis, male sex was a significant risk factor for SSI (p = 0.01). In multivariate analysis including multiple confounders' such as comorbidities and perioperative factors, there was no association between male sex and risk of SSI (odds ratio (OR) 1.1 [CI 0.8-1.4]). Independent risk factors for SSI in multivariate analysis were BMI ≥ 30 kg/m (OR 1.8 [CI 1.3-2.3]), duration of surgery > 75th percentile (OR 2.3 [1.8-2.9]), high contamination level (OR 1.3 [1.0-1.6]), laparotomy (OR 1.3 [1.0-1.7]), previous laparotomy (OR 1.4 [1.1-1.7]), blood transfusion (OR 1.7 [1.2-2.4]), cancer (OR 1.3 [1.0-1.8] and malnutrition (OR 2.5 [1.8-3.4]).
CONCLUSION
Under elimination of relevant confounders, there is no significant correlation between sex and risk of SSI after abdominal surgery.
目的
男性性别被认为是手术部位感染（SSI）的危险因素，这一观点存在争议。本研究的目的是评估在消除相关混杂因素后，性别对腹部手术 SSI 的影响。
方法
评估了来自瑞士 4 家医院的多中心前瞻性数据库中 6603 例接受腹部手术患者的临床病理数据，包括 2015 年至 2018 年的患者。根据术后 SSI 对患者进行分层，并使用单因素和多因素分析确定 SSI 的危险因素。
结果
在 6603 例患者中，有 649 例（9.8%）报告了 SSI。SSI 与再次手术（22.7%比 3.4%，p<0.001）、死亡率增加（4.6%比 0.9%，p<0.001）和住院时间超过第 75 百分位数的比例增加（57.0%比 17.9%，p<0.001）显著相关。单因素分析显示，男性是 SSI 的显著危险因素（p=0.01）。在包括合并症和围手术期因素等多种混杂因素的多因素分析中，男性与 SSI 风险之间没有关联（优势比（OR）1.1 [95%CI 0.8-1.4]）。多因素分析中 SSI 的独立危险因素包括 BMI≥30 kg/m（OR 1.8 [95%CI 1.3-2.3]）、手术时间超过第 75 百分位数（OR 2.3 [1.8-2.9]）、高污染程度（OR 1.3 [1.0-1.6]）、剖腹手术（OR 1.3 [1.0-1.7]）、既往剖腹手术（OR 1.4 [1.1-1.7]）、输血（OR 1.7 [1.2-2.4]）、癌症（OR 1.3 [1.0-1.8]）和营养不良（OR 2.5 [1.8-3.4]）。
结论
在消除相关混杂因素后，性别与腹部手术后 SSI 风险之间无显著相关性。
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