Lam Fai, Liao Chien-Chang, Chen Ta-Liang, Huang Yu-Min, Lee Yuarn-Jang, Chiou Hung-Yi
School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.
Front Med (Lausanne). 2023 Jun 9;10:1117885. doi: 10.3389/fmed.2023.1117885. eCollection 2023.
The influence of recent influenza infection on perioperative outcomes is not completely understood.
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.
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.
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.
近期流感感染对围手术期结局的影响尚未完全明确。
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。
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。
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。
