Sotirović Jelena, Rančić Nemanja, Pavićević Ljubomir, Baletić Nenad, Dimić Aleksandar, Čukić Ognjen, Perić Aleksandar, Milojević Milanko, Ljubenović Nenad, Milošević Darko, Šuljagić Vesna
Clinic for Otorhinolaryngology, Military Medical Academy, 11000 Belgrade, Serbia.
Medical Faculty, Military Medical Academy, University of Defence, 11000 Belgrade, Serbia.
Antibiotics (Basel). 2024 Sep 25;13(10):918. doi: 10.3390/antibiotics13100918.
Surgical site infection (SSI) in laryngeal cancer (LC) patients significantly increases morbidity and may postpone adjuvant therapy. Additionally, SSI can prolong hospitalization, thus representing a burden for the healthcare system. Most of the published studies refer to SSI after salvage laryngectomy.
The present prospective cohort study aimed to clarify the incidence and factors associated with SSI in patients after primary open surgery for LC. Through regular hospital surveillance of patients who underwent primary partial or total laryngectomy, we gathered 24 putative factors and identified SSI from 2013 to 2022. Patients with SSI were compared with patients without SSI.
SSI was observed in 21 (6.6%) of 319 patients. ULRA showed that the occurrence of SSI was significantly associated with the American Society of Anesthesiologists (ASA) score, other postoperative healthcare-associated (HAI) infection, T classification, N classification, advanced clinical stage (III-IV), length of stay (LOS), duration of drainage, and the National Healthcare Safety Network (NHSN) risk index. Multivariate logistic regression analysis identified two independent factors associated with SSI occurring in these patients: duration of drainage (RR (relative risk) 1.593; 95% CI 1.159-2.189; = 0.004) and LOS (RR: 1.074; 95% CI: 1.037-1.112; < 0.001).
Our study provided insight into the burden of SSI in LC patients, highlighting several priority areas and targets for quality improvement.
喉癌（LC）患者的手术部位感染（SSI）显著增加发病率，并可能推迟辅助治疗。此外，SSI会延长住院时间，因此给医疗系统带来负担。大多数已发表的研究涉及挽救性喉切除术后的SSI。
本前瞻性队列研究旨在阐明原发性开放性LC手术后患者SSI的发生率及相关因素。通过对接受原发性部分或全喉切除术患者的定期医院监测，我们收集了24个可能的因素，并确定了2013年至2022年期间的SSI情况。将发生SSI的患者与未发生SSI的患者进行比较。
319例患者中有21例（6.6%）发生了SSI。单因素逻辑回归分析表明，SSI的发生与美国麻醉医师协会（ASA）评分、其他术后医疗相关感染（HAI）、T分期、N分期、晚期临床分期（III-IV期）、住院时间（LOS）、引流持续时间以及国家医疗安全网络（NHSN）风险指数显著相关。多因素逻辑回归分析确定了与这些患者发生SSI相关的两个独立因素：引流持续时间（相对风险（RR）1.593；95%置信区间1.159-2.189；P = 0.004）和LOS（RR：1.074；95%置信区间：1.037-1.112；P < 0.001）。
我们的研究深入了解了LC患者SSI的负担，突出了几个质量改进的重点领域和目标。
