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新冠疫情期间加强医院感染预防对老年外科手术患者术后肺炎的影响

Impact of Enhanced in-Hospital Infection Prevention During the COVID-19 Pandemic on Postoperative Pneumonia in Older Surgical Patients.

作者信息

Ju Jae-Woo, You Jiwon, Hong Hyunsook, Kang Chang Kyung, Kim Won Ho, Lee Ho-Jin

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea.

出版信息

Int J Gen Med. 2023 May 23;16:1943-1951. doi: 10.2147/IJGM.S411502. eCollection 2023.

Abstract

PURPOSE

We aimed to investigate the impact of enhanced in-hospital infection prevention during the coronavirus disease 2019 (COVID-19) pandemic on postoperative pneumonia in older surgical patients.

PATIENTS AND METHODS

We retrospectively reviewed the electronic medical records of consecutive patients ≥70 years who underwent elective surgery between 2017 and 2021 at our institution. All perioperative variables were retrieved from the electronic medical records. The primary outcome was new-onset postoperative pneumonia during the hospitalization period. Since February 2020, our institution implemented a series of policies to enhance infection prevention, hence patients were divided into groups according to whether they underwent surgery before or during the COVID-19 pandemic. An interrupted time series analysis was performed to evaluate the difference between pre- and post-intervention slopes of the primary outcome.

RESULTS

Among the 29,387 patients included in the study, 10,547 patients underwent surgery during the COVID-19 pandemic. Although there was a decreasing trend of the monthly incidence rate of postoperative pneumonia compared to before the COVID-19 pandemic, there was no statistical significance in the trend (slope before COVID-19 period: β-coefficient, -0.007; 95% CI, -0.022 to 0.007).

CONCLUSION

Our study revealed that enhanced in-hospital infection prevention implemented to manage the COVID-19 pandemic did not significantly affect the decreasing trend of postoperative pneumonia at our institution.

摘要

目的

我们旨在调查2019冠状病毒病(COVID-19)大流行期间加强医院内感染预防对老年外科手术患者术后肺炎的影响。

患者与方法

我们回顾性分析了2017年至2021年期间在本机构接受择期手术的连续≥70岁患者的电子病历。所有围手术期变量均从电子病历中获取。主要结局是住院期间新发的术后肺炎。自2020年2月起,本机构实施了一系列加强感染预防的政策,因此根据患者是在COVID-19大流行之前还是期间接受手术进行分组。进行了中断时间序列分析,以评估主要结局干预前后斜率的差异。

结果

在纳入研究的29387例患者中,10547例患者在COVID-19大流行期间接受了手术。尽管与COVID-19大流行之前相比,术后肺炎的月发病率呈下降趋势,但该趋势无统计学意义(COVID-19时期之前的斜率:β系数,-0.007;95%CI,-0.022至0.007)。

结论

我们的研究表明,为应对COVID-19大流行而实施的加强医院内感染预防措施,对本机构术后肺炎的下降趋势没有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/932e/10224724/1b6ba0263656/IJGM-16-1943-g0001.jpg

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