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近期患流感和未患流感患者的手术后结局:一项基于全国人口的研究。

Outcomes after surgery in patients with and without recent influenza: a nationwide population-based study.

作者信息

Lam Fai, Liao Chien-Chang, Chen Ta-Liang, Huang Yu-Min, Lee Yuarn-Jang, Chiou Hung-Yi

机构信息

School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.

Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.

出版信息

Front Med (Lausanne). 2023 Jun 9;10:1117885. doi: 10.3389/fmed.2023.1117885. eCollection 2023.

Abstract

BACKGROUND

The influence of recent influenza infection on perioperative outcomes is not completely understood.

METHOD

Using Taiwan's National Health Insurance Research Data from 2008 to 2013, we conducted a surgical cohort study, which included 20,544 matched patients with a recent history of influenza and 10,272 matched patients without. The main outcomes were postoperative complications and mortality. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the complications and for mortality in patients with a history of influenza within 1-14 days or 15-30 days compared with non-influenza controls.

RESULTS

Compared with patients who had no influenza, patients with influenza within preoperative days 1-7 had increased risks of postoperative pneumonia (OR 2.22, 95% CI 1.81-2.73), septicemia (OR 1.98, 95% CI 1.70-2.31), acute renal failure (OR 2.10, 95% CI 1.47-3.00), and urinary tract infection (OR 1.45, 95% CI 1.23-1.70). An increased risk of intensive care admission, prolonged length of stay, and higher medical expenditure was noted in patients with history of influenza within 1-14 days.

CONCLUSION

We found that there was an association between influenza within 14 days preoperatively and the increased risk of postoperative complications, particularly with the occurrence of influenza within 7 days prior to surgery.

摘要

背景

近期流感感染对围手术期结局的影响尚未完全明确。

方法

利用2008年至2013年台湾地区国民健康保险研究数据,我们开展了一项外科队列研究,纳入了20544例近期有流感病史的匹配患者以及10272例无流感病史的匹配患者。主要结局为术后并发症和死亡率。我们计算了流感病史患者在术前1 - 14天或15 - 30天内发生并发症和死亡的比值比(OR)及95%置信区间(CI),并与无流感的对照组进行比较。

结果

与无流感患者相比,术前1 - 7天患流感的患者术后发生肺炎(OR 2.22,95% CI 1.81 - 2.73)、败血症(OR 1.98,95% CI 1.70 - 2.31)、急性肾衰竭(OR 2.10,95% CI 1.47 - 3.00)及尿路感染(OR 1.45,95% CI 1.23 - 1.70)的风险增加。术前1 - 14天有流感病史的患者入住重症监护病房的风险增加、住院时间延长且医疗费用更高。

结论

我们发现术前14天内感染流感与术后并发症风险增加之间存在关联,尤其是术前7天内发生流感的情况。

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