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Abstract：
BACKGROUND: The selection of prophylactic antibiotics for preventing post-operative pulmonary infections in smoking patients undergoing video-assisted thoracoscopic lung surgery (VATLS) is not clear.
METHODS: In this retrospective cohort study, the outcomes of 572 smoking patients undergoing VATLS with prophylactic cefazolin/cefuroxime or other antibiotics were analyzed. Patients were classified as cefazolin/cefuroxime group and the control group. A 1:1 propensity score matching was also performed.
RESULTS: The primary outcome of the incidence of post-operative pulmonary infection did not differ significantly between the two groups (23.7% vs 30.5%, RR = 0.777, 95%CI 0.564 ~ 1.070 p = 0.113). Similarly, secondary outcomes including the incidence of post-operative fever, the white blood cell count and neutrophils on the 3rd day after the surgery, and time for blood routine test recovery were all found without significant difference between the two groups. In the multivariate logistic regression model, no association was found between prophylactic use of cefazolin/cefuroxime and post-operative pulmonary infections after controlling other possible confounding factors (OR = 0.685, 95%CI 0.441 ~ 1.065, p = 0.093).
CONCLUSIONS: Prophylactic use of cefazolin/cefuroxime was not associated with more adverse clinical outcomes among smoking populations undergoing VATLS when compared with broad-spectrum antibiotics and the two drugs are still feasible for peri-operative prophylactic use for smoking population before the surgery.
METHODS: In this retrospective cohort study, the outcomes of 572 smoking patients undergoing VATLS with prophylactic cefazolin/cefuroxime or other antibiotics were analyzed. Patients were classified as cefazolin/cefuroxime group and the control group. A 1:1 propensity score matching was also performed.
RESULTS: The primary outcome of the incidence of post-operative pulmonary infection did not differ significantly between the two groups (23.7% vs 30.5%, RR = 0.777, 95%CI 0.564 ~ 1.070 p = 0.113). Similarly, secondary outcomes including the incidence of post-operative fever, the white blood cell count and neutrophils on the 3rd day after the surgery, and time for blood routine test recovery were all found without significant difference between the two groups. In the multivariate logistic regression model, no association was found between prophylactic use of cefazolin/cefuroxime and post-operative pulmonary infections after controlling other possible confounding factors (OR = 0.685, 95%CI 0.441 ~ 1.065, p = 0.093).
CONCLUSIONS: Prophylactic use of cefazolin/cefuroxime was not associated with more adverse clinical outcomes among smoking populations undergoing VATLS when compared with broad-spectrum antibiotics and the two drugs are still feasible for peri-operative prophylactic use for smoking population before the surgery.
摘要：
背景：在接受电视胸腔镜肺手术（VATLS）的吸烟患者中，预防术后肺部感染的预防性抗生素的选择尚不清楚。
方法：在这项回顾性队列研究中，我们分析了572例吸烟患者接受VATLS预防性使用头孢唑啉/头孢呋辛或其他抗生素的结局.将患者分为头孢唑啉/头孢呋辛组和对照组。还进行了1:1倾向评分匹配。
结果：两组术后肺部感染发生率的主要结局没有显着差异（23.7％vs30.5％，RR=0.777，95CI0.564~1.070p=0.113)。同样，次要结果包括术后发热的发生率,手术后第3天的白细胞计数和中性粒细胞，两组患者血常规恢复时间及血常规恢复时间均无显著性差异。在多元逻辑回归模型中，在控制其他可能的混杂因素后,预防性使用头孢唑啉/头孢呋辛与术后肺部感染无相关性(OR=0.685,95CI0.441~1.065,p=0.093).
结论：与广谱抗生素相比，在接受VATLS的吸烟人群中，预防性使用头孢唑啉/头孢呋辛与更多的不良临床结局无关，并且这两种药物对于手术前吸烟人群的围手术期预防性使用仍然可行。
方法：在这项回顾性队列研究中，我们分析了572例吸烟患者接受VATLS预防性使用头孢唑啉/头孢呋辛或其他抗生素的结局.将患者分为头孢唑啉/头孢呋辛组和对照组。还进行了1:1倾向评分匹配。
结果：两组术后肺部感染发生率的主要结局没有显着差异（23.7％vs30.5％，RR=0.777，95CI0.564~1.070p=0.113)。同样，次要结果包括术后发热的发生率,手术后第3天的白细胞计数和中性粒细胞，两组患者血常规恢复时间及血常规恢复时间均无显著性差异。在多元逻辑回归模型中，在控制其他可能的混杂因素后,预防性使用头孢唑啉/头孢呋辛与术后肺部感染无相关性(OR=0.685,95CI0.441~1.065,p=0.093).
结论：与广谱抗生素相比，在接受VATLS的吸烟人群中，预防性使用头孢唑啉/头孢呋辛与更多的不良临床结局无关，并且这两种药物对于手术前吸烟人群的围手术期预防性使用仍然可行。
