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术前25-羟基维生素D缺乏与口腔肿瘤外科手术后手术部位感染之间的关联:印度西北部一家三级癌症中心的横断面研究

Association Between Pre-operative 25-Hydroxy Vitamin D Deficiency and Surgical Site Infection After Oral Cavity Oncology Surgery: a Cross-Sectional Study in a Tertiary Cancer Center in Northwestern India.

作者信息

Lakhera Kamal Kishor, Babu Agil, Patel Pinakin, Singh Suresh, Singhal Pranav Mohan, Nutakki Srikanth, Mehta Deeksha, Daima Mahesh

机构信息

Department of Surgical Oncology, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India.

出版信息

Indian J Surg Oncol. 2024 Jun;15(2):218-224. doi: 10.1007/s13193-023-01862-1. Epub 2023 Dec 22.

Abstract

Surgical site infections (SSI) following head and neck oncology surgery can lead to significant morbidity and healthcare costs. This cross-sectional study was used to investigate a potential link between pre-operative 25-hydroxy vitamin D deficiency and an increased risk of surgical site infections in patients undergoing oral cavity oncology surgery. This cross-sectional study was conducted at a tertiary center in northwestern India from May 2022 to May 2023. Patients scheduled to undergo oral cavity oncology surgery during this period were eligible for inclusion. Patients with complete pre-operative 25-hydroxy vitamin D levels and documented post-operative wound infection status were included in the analysis. A total of 85 patients who underwent oral cavity oncology surgery were included in the study. Among them, 30.58% (26 patients) had pre-operative vitamin D deficiency, The overall incidence of surgical site infection (SSI) was 36.47% (31 patients). Among the patients with pre-operative vitamin D deficiency, 23 (88.5%) developed surgical site infections. Finally, pre-operative levels of 25-hydroxy vitamin D, pre-operative poor oral hygiene, and low albumin were confirmed as statistically significant independent predictors of SSI. After doing multivariate analysis, vitamin D deficiency was found to be a significant predictor of post-op wound infection [adjusted odds ratio - 0.71 (95% CI 0.61-0.82); value < 0.001]. This study highlights the significant association between pre-operative 25-hydroxy vitamin D deficiency and an increased risk of surgical site infections in patients. Vitamin D plays a crucial role in modulating the immune response, promoting antimicrobial peptides, and enhancing wound healing. These findings support the importance of assessing and addressing vitamin D deficiency in patients scheduled for oral cavity oncology surgery to potentially reduce the incidence of SSIs.

摘要

头颈部肿瘤手术后的手术部位感染(SSI)可导致严重的发病情况和医疗费用。这项横断面研究旨在调查术前25-羟基维生素D缺乏与口腔肿瘤手术患者手术部位感染风险增加之间的潜在联系。这项横断面研究于2022年5月至2023年5月在印度西北部的一家三级中心进行。在此期间计划接受口腔肿瘤手术的患者符合纳入条件。分析纳入了术前25-羟基维生素D水平完整且有术后伤口感染记录的患者。共有85例接受口腔肿瘤手术的患者纳入研究。其中,30.58%(26例患者)术前存在维生素D缺乏,手术部位感染(SSI)的总体发生率为36.47%(31例患者)。在术前维生素D缺乏的患者中,23例(88.5%)发生了手术部位感染。最后,术前25-羟基维生素D水平、术前口腔卫生差和低白蛋白被确认为SSI的统计学显著独立预测因素。进行多变量分析后,发现维生素D缺乏是术后伤口感染的显著预测因素[调整后的优势比-0.71(95%可信区间0.61-0.82);P值<0.001]。本研究强调了术前25-羟基维生素D缺乏与患者手术部位感染风险增加之间的显著关联。维生素D在调节免疫反应、促进抗菌肽和增强伤口愈合方面起着关键作用。这些发现支持了在计划进行口腔肿瘤手术的患者中评估和解决维生素D缺乏问题以潜在降低SSIs发生率的重要性。

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本文引用的文献

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Association between Pre-Operative 25-Hydroxy Vitamin D Deficiency and Surgical Site Infection after Right Hemicolectomy Surgery.
Surg Infect (Larchmt). 2022 Nov;23(9):829-833. doi: 10.1089/sur.2022.122. Epub 2022 Oct 10.
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