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肋骨骨折切开复位内固定术后伤口感染的危险因素综合分析。

Comprehensive analysis of risk factors for postoperative wound infection following open reduction and internal fixation of Rib fractures.

机构信息

Cardio-Thoracic Surgery Department, Qionghai People's Hospital, Qionghai City, 571400, Hainan Province, China.

Gynecology-Breast And Thyroid Surgery Department, Qionghai People's Hospital, No. 33 Fuhai Road, Jiaji Town, Qionghai City, 571400, Hainan Province, China.

出版信息

BMC Infect Dis. 2024 Sep 19;24(1):1013. doi: 10.1186/s12879-024-09946-1.

Abstract

BACKGROUND

Postoperative wound infections (PWIs) significantly impact patient outcomes following open reduction and internal fixation (ORIF) of rib fractures. Identifying and understanding risk factors associated with these infections are crucial for improving surgical outcomes and patient care.

METHODS

This retrospective study, conducted from January 2020 to October 2023 at our institution, aimed to analyze the risk factors for PWIs in patients undergoing ORIF for rib fractures. A total of 150 patients were included, with 50 in the infected group and 100 in the non-infected control group, matched for demographic and clinical characteristics. Data on variables such as intraoperative blood loss, hospital stay duration, body mass index (BMI), operation time, presence of anemia, drainage time, diabetes mellitus status, smoking habits, and age were collected. Statistical analysis involved univariate and multivariate logistic regression using SPSS software (Version 27.0), with p-values < 0.05 considered statistically significant.

RESULTS

Univariate analysis revealed no significant association between intraoperative blood loss or hospital stay duration and PWIs. However, operation time ≥ 5 h, anemia, drainage time ≥ 7 days, diabetes mellitus, smoking, and age ≥ 60 years were significantly associated with higher PWI rates. Multivariate logistic regression confirmed these factors as independent predictors of PWIs, with operation time and diabetes mellitus showing particularly strong associations.

CONCLUSIONS

Prolonged operation time, anemia, extended drainage, diabetes mellitus, smoking, and advanced age significantly increase the risk of PWIs following ORIF for rib fractures. Early identification and targeted management of these risk factors are essential to reduce the incidence of infections and improve postoperative outcomes.

摘要

背景

术后伤口感染(PWIs)显著影响肋骨骨折切开复位内固定(ORIF)后的患者结局。确定并了解与这些感染相关的风险因素对于改善手术结果和患者护理至关重要。

方法

本回顾性研究于 2020 年 1 月至 2023 年 10 月在我院进行,旨在分析接受 ORIF 治疗肋骨骨折的患者发生 PWIs 的风险因素。共纳入 150 例患者,其中感染组 50 例,非感染对照组 100 例,两组在人口统计学和临床特征方面相匹配。收集了术中失血量、住院时间、体重指数(BMI)、手术时间、贫血、引流时间、糖尿病状态、吸烟习惯和年龄等变量的数据。使用 SPSS 软件(版本 27.0)进行单变量和多变量逻辑回归分析,p 值<0.05 被认为具有统计学意义。

结果

单变量分析显示术中失血量或住院时间与 PWIs 之间无显著关联。然而,手术时间≥5 小时、贫血、引流时间≥7 天、糖尿病、吸烟和年龄≥60 岁与更高的 PWI 发生率显著相关。多变量逻辑回归证实这些因素是 PWIs 的独立预测因素,手术时间和糖尿病表现出特别强的关联。

结论

手术时间延长、贫血、引流时间延长、糖尿病、吸烟和高龄显著增加了肋骨骨折 ORIF 后 PWIs 的风险。早期识别和针对性管理这些风险因素对于降低感染发生率和改善术后结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c43/11414111/44caa5e90cb9/12879_2024_9946_Fig1_HTML.jpg

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