Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China.
Guangxi Medical University, Nanning, Guangxi, China.
Surg Infect (Larchmt). 2023 Sep;24(7):588-597. doi: 10.1089/sur.2023.130. Epub 2023 Aug 10.
This study aims to analyze the risk factors for post-operative pulmonary infection in patients with brain tumors by meta-analysis to provide a reference for its prevention. PubMed, Embase, Web of Science, Cochrane Library, Ovid, and four Chinese databases (CNKI, SinoMed, VIP, and Wanfang databases) were searched for studies covering risk factors of pulmonary infection in patients with brain tumors, limited to the duration from the dates of inception of the respective databases to December 31, 2022. The Newcastle-Ottawa scale was used to assess the evidence. A meta-analysis of the factors affecting the incidence of pulmonary infection was performed using Revman 5.4 software. Twelve studies were selected, covering 35,615 patients with brain tumors, among whom pulmonary infection occurred in 1,635 cases with an accumulated incidence of 4.6%, including 38 related risk factors. Meta-analysis results indicated: history of chronic pulmonary disease (odds ratio [OR], 5.74; 95% confidence interval [CI], 1.34-24.51; p = 0.02], diabetes mellitus (OR, 1.58; 95% CI, 1.29-1.95; p < 0.0001), history of cardiovascular disease (OR, 3.97; 95% CI, 2.18-7.24; p < 0.00001), age ≥60 years (OR, 1.55; 95% CI, 1.12-2.15; p = 0.009)], operation time ≥3 hours (OR, 1.03; 95% CI, 1.00-1.05; p = 0.03], Glasgow Coma Scale (GCS) score <13 (OR, 3.5; 95% CI, 1.90-6.46; p < 0.0001), and the American Society of Anesthesiologists classification (ASA) ≥3 (OR, 2.03; 95% CI, 1.68-2.46; p < 0.00001) as independent risk factors. History of chronic pulmonary disease, diabetes mellitus, history of cardiovascular disease, age ≥60 years, operation time ≥3 hours, GCS score <13, and the ASA grade ≥3 are independent risk factors for post-operative pulmonary infection in patients with brain tumors, which nursing staff should be aware of.
本研究旨在通过荟萃分析分析脑肿瘤患者术后肺部感染的危险因素,为其预防提供参考。检索了 PubMed、Embase、Web of Science、Cochrane 图书馆、Ovid、四个中文数据库(CNKI、SinoMed、VIP 和万方数据库),纳入了脑肿瘤患者肺部感染危险因素的研究,时间限定为各自数据库的成立日期至 2022 年 12 月 31 日。使用纽卡斯尔-渥太华量表评估证据。使用 Revman 5.4 软件对影响肺部感染发生率的因素进行荟萃分析。 选择了 12 项研究,共纳入 35615 例脑肿瘤患者,其中 1635 例发生肺部感染,累积发生率为 4.6%,包括 38 个相关危险因素。荟萃分析结果表明:慢性肺部疾病史(优势比 [OR],5.74;95%置信区间 [CI],1.34-24.51;p=0.02)、糖尿病(OR,1.58;95%CI,1.29-1.95;p<0.0001)、心血管疾病史(OR,3.97;95%CI,2.18-7.24;p<0.00001)、年龄≥60 岁(OR,1.55;95%CI,1.12-2.15;p=0.009)]、手术时间≥3 小时(OR,1.03;95%CI,1.00-1.05;p=0.03)]、格拉斯哥昏迷评分(GCS)评分<13(OR,3.5;95%CI,1.90-6.46;p<0.0001)和美国麻醉师协会(ASA)分级≥3(OR,2.03;95%CI,1.68-2.46;p<0.00001)是独立的危险因素。慢性肺部疾病史、糖尿病、心血管疾病史、年龄≥60 岁、手术时间≥3 小时、GCS 评分<13 和 ASA 分级≥3 是脑肿瘤患者术后肺部感染的独立危险因素,护理人员应予以重视。