美国麻醉医师协会评分及手术时间对腹部大手术手术部位感染率的影响
The Effect of American Society of Anesthesiologists Score and Operative Time on Surgical Site Infection Rates in Major Abdominal Surgeries.
作者信息
Bhat Rayees Ahmad, Isaac Natasha Varghese, Joy Jeffin, Chandran Deepika, Jacob Kevin Joseph, Lobo Samantha
机构信息
Department of Surgery, Hamdard Institute of Medical Sciences and Research, New Delhi, IND.
Department of Medicine, St. John's Medical College Hospital, Rajiv Gandhi University of Health Sciences, Bangalore, IND.
出版信息
Cureus. 2024 Feb 28;16(2):e55138. doi: 10.7759/cureus.55138. eCollection 2024 Feb.
BACKGROUND
The objective of this study was to evaluate the influence of two crucial variables, the American Society of Anesthesiologists (ASA) score and operative time, on the occurrence of surgical site infections (SSIs) in the context of major abdominal surgical procedures.
METHODOLOGY
A cross-sectional research study involved patients undergoing various gastrointestinal surgical procedures. Surgical details, procedure duration, and ASA score were meticulously documented. Patients were observed for surgical site infections (SSIs) during their inpatient stay until discharge. Following their discharge, patients were monitored in the outpatient department for a minimum of 30 days post-surgery, and those who underwent mesh procedures were observed for one year.
RESULTS
In the overall study population, surgical site infections were identified in 42 cases, constituting 6.7%. There was a significant association between ASA grade and the incidence of surgical site infections (p=0.001), indicating a higher prevalence of infections in cases with elevated ASA grades. Furthermore, a statistically significant association exists between the average duration of surgery and the occurrence of surgical site infections (p=0.001). The mean surgery duration for cases with infections is reported as 206.33 min, with a standard deviation of 103.73, while for cases without infections, the mean duration is 99.72 min, with a standard deviation of 79.71. In the multivariate analysis, it was found that an ASA score of 3 or higher and operative time exceeding 90 min were identified as independent factors for predicting the likelihood of surgical site infections.
CONCLUSION
The significant associations identified between the American Society of Anesthesiologists (ASA) grade, average surgery duration, and SSIs underscore the importance of comprehensive preoperative assessment and procedural management in infection prevention.
背景
本研究的目的是评估两个关键变量，即美国麻醉医师协会（ASA）评分和手术时间，对腹部大手术中手术部位感染（SSIs）发生情况的影响。
方法
一项横断面研究涉及接受各种胃肠外科手术的患者。详细记录手术细节、手术时长和ASA评分。在患者住院直至出院期间观察其手术部位感染情况。出院后，在门诊部对患者进行至少30天的术后监测，接受网状植入手术的患者观察一年。
结果
在整个研究人群中，共识别出42例手术部位感染病例，占6.7%。ASA分级与手术部位感染发生率之间存在显著关联（p = 0.001），表明ASA分级较高的病例感染发生率更高。此外，手术平均时长与手术部位感染的发生之间存在统计学上的显著关联（p = 0.001）。报告显示，感染病例的平均手术时长为206.33分钟，标准差为103.73，而未感染病例的平均时长为99.72分钟，标准差为79.71。在多变量分析中，发现ASA评分为3或更高以及手术时间超过90分钟是预测手术部位感染可能性的独立因素。
结论
美国麻醉医师协会（ASA）分级、平均手术时长与手术部位感染之间的显著关联强调了全面术前评估和手术管理在预防感染方面的重要性。
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