Abstract：
BACKGROUND: The coronavirus 2019 (COVID-19) pandemic led to major disruptions in surgical activity, particularly in the first year (2020). The objective of this study was to assess the impact of surgical reorganization on surgical outcomes in Northern Italy in 2020 and 2021.
METHODS: A retrospective cohort study was conducted among 30 hospitals participating in the surveillance system for surgical site infections (SSIs). Abdominal surgery procedures performed between 2018 and 2021 were considered. Predicted SSI rates for 2020 and 2021 were estimated based on 2018-2019 data and compared with observed rates. Independent predictors for SSI were investigated using logistic regression, including procedure year.
RESULTS: 7605 procedures were included. Significant differences in case-mix were found comparing the three time periods. Observed SSI rates among all patients in 2020 were significantly lower than expected based on 2018-2019 SSI rates (p 0.0465). Patients undergoing procedures other than cancer surgery in 2020 had significantly lower odds for SSI (odds ratio, OR 0.52, 95 % confidence interval, CI 0.3-0.89, p 0.018) and patients undergoing surgery in 2021 had significantly higher odds for SSI (OR 1.49, 95 % CI 1.07-2.09, p 0.019) compared to 2018-2019.
CONCLUSIONS: Enhanced infection prevention and control (IPC) measures could explain the reduced SSI risk during the first pandemic year. IPC practices should continue to be reinforced beyond the pandemic context.
METHODS: A retrospective cohort study was conducted among 30 hospitals participating in the surveillance system for surgical site infections (SSIs). Abdominal surgery procedures performed between 2018 and 2021 were considered. Predicted SSI rates for 2020 and 2021 were estimated based on 2018-2019 data and compared with observed rates. Independent predictors for SSI were investigated using logistic regression, including procedure year.
RESULTS: 7605 procedures were included. Significant differences in case-mix were found comparing the three time periods. Observed SSI rates among all patients in 2020 were significantly lower than expected based on 2018-2019 SSI rates (p 0.0465). Patients undergoing procedures other than cancer surgery in 2020 had significantly lower odds for SSI (odds ratio, OR 0.52, 95 % confidence interval, CI 0.3-0.89, p 0.018) and patients undergoing surgery in 2021 had significantly higher odds for SSI (OR 1.49, 95 % CI 1.07-2.09, p 0.019) compared to 2018-2019.
CONCLUSIONS: Enhanced infection prevention and control (IPC) measures could explain the reduced SSI risk during the first pandemic year. IPC practices should continue to be reinforced beyond the pandemic context.
摘要：
背景：2019年冠状病毒（COVID-19）大流行导致手术活动严重中断，尤其是在第一年（2020年）。这项研究的目的是评估2020年和2021年意大利北部手术重组对手术结果的影响。
方法：在参与手术部位感染（SSIs）监测系统的30家医院中进行了一项回顾性队列研究。考虑在2018年至2021年之间进行的腹部外科手术。根据2018-2019年的数据估算2020年和2021年的预测SSI率，并与观察到的比率进行比较。使用逻辑回归调查了SSI的独立预测因素，包括程序年份。
结果：包括7605程序。比较三个时间段，发现病例组合存在显着差异。根据2018-2019年的SSI率（p0.0465），观察到的2020年所有患者的SSI率均显着低于预期。2020年接受癌症手术以外手术的患者发生SSI的几率显著降低(比值比，或0.52，95%置信区间，CI0.3-0.89，p0.018），与2018-2019年相比，2021年接受手术的患者发生SSI的几率明显更高（OR1.49，95%CI1.07-2.09，p0.019）。
结论：加强感染预防和控制（IPC）措施可以解释在大流行的第一年降低的SSI风险。在大流行范围之外，应继续加强IPC做法。
方法：在参与手术部位感染（SSIs）监测系统的30家医院中进行了一项回顾性队列研究。考虑在2018年至2021年之间进行的腹部外科手术。根据2018-2019年的数据估算2020年和2021年的预测SSI率，并与观察到的比率进行比较。使用逻辑回归调查了SSI的独立预测因素，包括程序年份。
结果：包括7605程序。比较三个时间段，发现病例组合存在显着差异。根据2018-2019年的SSI率（p0.0465），观察到的2020年所有患者的SSI率均显着低于预期。2020年接受癌症手术以外手术的患者发生SSI的几率显著降低(比值比，或0.52，95%置信区间，CI0.3-0.89，p0.018），与2018-2019年相比，2021年接受手术的患者发生SSI的几率明显更高（OR1.49，95%CI1.07-2.09，p0.019）。
结论：加强感染预防和控制（IPC）措施可以解释在大流行的第一年降低的SSI风险。在大流行范围之外，应继续加强IPC做法。
