DiPiro J T, Martindale R G, Bakst A, Vacani P F, Watson P, Miller M T
College of Pharmacy, University of Georgia, Athens, Department of Surgery, USA.
Am J Health Syst Pharm. 1998 Apr 15;55(8):777-81. doi: 10.1093/ajhp/55.8.777.
In-hospital mortality, length of stay (LOS), and level of postdischarge care in infected and noninfected surgical patients were studied. An analysis was conducted of a database that included diagnostic, procedure, and drug data collected when surgical patients were discharged from the hospital. Hospitals consisted of 90 nongovernment, nonspecialty, teaching, and nonteaching acute care hospitals of more than 100 beds. Patients in the database included 288,906 patients of all ages hospitalized between July and September 1994. Patients selected of those who had undergone procedures likely to pose a moderate to high risk of infection. Of the 288,906 patients, 12,384 had undergone a moderate- to high-risk procedure; of these, 1,479 (11.9%) had had an infection during their hospitalization. Infection rates ranged from 1.9% to 25.4%, depending on the procedure. The in-hospital mortality rate in infected patients was 14.5%, versus 1.8% for noninfected patients. Similarly, LOS in infected patients (median, 14 days) was substantially greater than in noninfected patients (4 days). About 24% of infected patients required additional professional care after discharge, compared with 7% of noninfected patients. Infection occurs in a substantial portion of surgical patients and is associated with a higher death rate, longer hospitalization, and more intense postdischarge care.
我们研究了感染和未感染的外科手术患者的院内死亡率、住院时间（LOS）以及出院后护理水平。对一个数据库进行了分析，该数据库包含外科手术患者出院时收集的诊断、手术和药物数据。这些医院包括90家非政府、非专科、教学和非教学性质的急性护理医院，床位超过100张。数据库中的患者包括1994年7月至9月期间住院的各年龄段的288,906名患者。所选患者为那些接受了可能带来中度至高度感染风险手术的患者。在这288,906名患者中，有12,384人接受了中度至高度风险的手术；其中，1479人（11.9%）在住院期间发生了感染。感染率因手术不同而在1.9%至25.4%之间。感染患者的院内死亡率为14.5%，未感染患者为1.8%。同样，感染患者的住院时间（中位数为14天）显著长于未感染患者（4天）。约24%的感染患者出院后需要额外的专业护理，而未感染患者这一比例为7%。感染在相当一部分外科手术患者中发生，并与更高的死亡率、更长的住院时间以及更密集的出院后护理相关。
