Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St Clair St, Ste 1600, Chicago, IL, 60611, USA.
Florida Dermatology and Skin Cancer Centers, Lake Wales, FL, USA.
Arch Dermatol Res. 2023 Dec 13;316(1):43. doi: 10.1007/s00403-023-02773-5.
Surgical site infections (SSIs) contribute to morbidity and are costly to the healthcare system. To identify factors associated with SSIs. Case-control study analyzing the Nationwide Readmission Database (NRD). We identified 45,445 SSIs. Infection rates were higher in those who were obese (BMI ≥ 30) (OR: 1.39, 95% CI 1.28-1.51), tobacco users (OR: 1.08, 95% CI 1.02-1.15), diagnosed with diabetes (OR: 1.16, 95% CI 1.10-1.22), with Elixhauser Comorbidity Index ≥ 2 (OR: 1.14, 95% CI 1.09-1.20), admitted to hospital for 4-6 days (OR: 1.35, 95% CI 1.29-1.42), in medium-size hospital (OR: 1.15, 95% CI 1.05-1.26), or large-size hospital (OR: 1.43, 95% CI 1.31-1.56). In contrast, patients who were 60-79 years old (OR: 0.78, 95% CI 0.73-0.84), 80 years or older (OR: 0.66, 95% CI 0.59-0.73), female (OR: 0.95, 95% CI 0.91-0.99), underweight (BMI < 18.5) (OR: 0.14, 95% CI 0.03-0.59), in a non-metropolitan hospital (OR: 0.83, 95% CI 0.75-0.91), self-pay (OR: 0.82, 95% CI 0.74-0.91), or covered by Medicare (OR: 0.86, 95% CI 0.80-0.91) had lower odds. Initial data entry to NRD is susceptible to human error. Patients who are obese, use tobacco, have multiple comorbidities, and have long hospital stays in medium-to-large-size hospitals are at risk of SSIs. Conversely, odds of SSIs are lower in females, age ≥ 60, BMI < 18.5, self-pay or Medicare (versus private insurance), or at smaller hospitals. Understanding factors associated with SSIs may help surgeons anticipate complications.
手术部位感染（SSI）会导致发病率增加，并给医疗保健系统带来高昂的成本。为了确定与 SSI 相关的因素，我们对全国再入院数据库（NRD）进行了病例对照研究。我们确定了 45445 例 SSI。肥胖（BMI≥30）（OR：1.39，95%CI 1.28-1.51）、吸烟（OR：1.08，95%CI 1.02-1.15）、诊断为糖尿病（OR：1.16，95%CI 1.10-1.22）、Elixhauser 合并症指数≥2（OR：1.14，95%CI 1.09-1.20）、住院 4-6 天（OR：1.35，95%CI 1.29-1.42）、在中等规模医院（OR：1.15，95%CI 1.05-1.26）或大型医院（OR：1.43，95%CI 1.31-1.56）的患者感染率更高。相比之下，年龄在 60-79 岁（OR：0.78，95%CI 0.73-0.84）、80 岁或以上（OR：0.66，95%CI 0.59-0.73）、女性（OR：0.95，95%CI 0.91-0.99）、体重过轻（BMI<18.5）（OR：0.14，95%CI 0.03-0.59）、在非大都市医院（OR：0.83，95%CI 0.75-0.91）、自费（OR：0.82，95%CI 0.74-0.91）或医疗保险（OR：0.86，95%CI 0.80-0.91）的患者发生 SSI 的可能性较低。NRD 的初始数据录入容易出现人为错误。肥胖、吸烟、合并多种疾病以及在中大型医院住院时间较长的患者存在 SSI 风险。相反，女性、年龄≥60 岁、BMI<18.5、自费或医疗保险（而非私人保险）或在较小的医院就诊的患者发生 SSI 的可能性较低。了解与 SSI 相关的因素可能有助于外科医生预测并发症。
