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开颅术后神经外科手术部位感染危险因素的荟萃分析。

A meta-analysis of the risk factors for neurosurgical surgical site infection following craniotomy.

机构信息

Department of Neurosurgery, Huaihe Hospital of Henan University, Kaifeng, China.

出版信息

Int Wound J. 2024 Apr;21(4):e14542. doi: 10.1111/iwj.14542. Epub 2023 Dec 22.

Abstract

The purpose of the meta-analysis was to evaluate and compare the risk factors for neurosurgical surgical site infection (SSI) after craniotomy. Using dichotomous or contentious random or fixed effect models, the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were computed based on the examination of the meta-analysis results. Eighteen analyses, covering 11 068 craniotomies between 2001 and 2023, were included in the current meta-analysis. Subjects with SSIs had a significantly younger age (MD, -2.49; 95% CI, -2.95 to -2.04, p < 0.001), longer operation duration (MD, 10.21; 95% CI, 6.49-13.94, p < 0.001) and longer length of postoperative hospital stay (MD, 1.52; 95% CI, 0.45-2.60, p = 0.006) compared to subjects with no SSI with craniotomy. However, no significant difference was found between craniotomy subjects with SSIs and with no SSI in gender (OR, 0.90; 95% CI, 0.76-1.07, p = 0.23), and combination with other infection (OR, 3.93; 95% CI, 0.28-56.01, p = 0.31). The data that were looked at showed that younger age, longer operation duration and longer length of postoperative hospital stay can be considered as risk factors of SSI in subjects with craniotomy; however, gender and combination with other infections are not. Nonetheless, consideration should be given to their values because several studies only involved a small number of patients, and there are not many studies available for some comparisons.

摘要

本荟萃分析的目的在于评估和比较开颅术后神经外科手术部位感染(SSI)的危险因素。基于荟萃分析结果的检验,使用二分类或连续随机或固定效应模型,计算比值比(OR)和均数差(MD)及其 95%置信区间(CI)。本荟萃分析纳入了 18 项分析,共涉及 2001 年至 2023 年间的 11068 例开颅手术。患有 SSI 的患者年龄明显更小(MD,-2.49;95%CI,-2.95 至-2.04,p<0.001)、手术时间更长(MD,10.21;95%CI,6.49-13.94,p<0.001)和术后住院时间更长(MD,1.52;95%CI,0.45-2.60,p=0.006)。然而,患有 SSI 的开颅手术患者与无 SSI 的患者在性别(OR,0.90;95%CI,0.76-1.07,p=0.23)和合并其他感染(OR,3.93;95%CI,0.28-56.01,p=0.31)方面无显著差异。所观察到的数据表明,年龄较小、手术时间较长和术后住院时间较长可被视为开颅术后 SSI 患者的危险因素;然而,性别和合并其他感染并非危险因素。然而,应考虑这些因素的价值,因为一些研究仅涉及少数患者,且某些比较的研究较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7cc/10961046/5e93e5c60e6f/IWJ-21-e14542-g006.jpg

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