■评估和比较CDC标准和ASEPSIS评分在确定剖宫产后手术部位感染方面的评估者之间的一致性。
■前瞻性观察性研究,包括在我们机构接受剖宫产的110例患者。手术伤口根据标准护理进行管理,并在第三张照片上拍照,第七,术后第30天或在任何评估期间出现并发症。三位专家外科医生回顾了前瞻性收集的数据和照片,并使用CDC标准和ASEPSIS评分对每个伤口进行了分类。使用Krippendorff的Alpha以线性权重确定CDC标准和ASEPSIS评分的评估者之间的协议,并与置信区间方法进行比较。
■CDC标准的加权α系数为0.587(95CI,0.411-0.763,p<0.001,根据Altman对加权一致系数的解释,“中度”一致),而ASEPSIS评分的加权α系数为0.856(95CI,0.733-0.980,p<0.001,“非常好”)。
■ASEPSIS评分为剖宫产后手术部位感染识别提供了“非常好”的评分者之间的共识,导致比CDC标准更客观的方法(“中等”评分者之间的协议)。ASEPSIS评分可以代表剖宫产术后手术部位感染管理和监测的客观工具,也通过摄影评价。
UNASSIGNED: To assess and compare the inter-rater agreement of the CDC criteria and the ASEPSIS score in identifying surgical site infections after cesarean section.
UNASSIGNED: Prospective observational study including 110 patients subjected to a cesarean section at our institution. Surgical wounds were managed according to standard care and were photographed on the third, seventh, and thirtieth postoperative day or during any evaluation in case of complications. Three expert surgeons reviewed the prospectively gathered data and photographs and classified each wound using CDC criteria and the ASEPSIS score. The inter-rater agreements of CDC criteria and ASEPSIS score were determined with Krippendorff\'s Alpha with linear weights and compared with a confidence interval approach.
UNASSIGNED: The weighted α coefficient for CDC criteria was 0.587 (95%CI, 0.411-0.763, p < 0.001, \"moderate\" agreement according to Altman\'s interpretation of weighted agreement coefficient), while the weighted α coefficient for the ASEPSIS score was 0.856 (95%CI, 0.733-0.980, p < 0.001, \"very good\" agreement).
UNASSIGNED: ASEPSIS score presents a \"very good\" inter-rater agreement for surgical site infections identification after cesarean, resulting in a more objective method than CDC criteria (\"moderate\" inter-rater agreement). ASEPSIS score could represent an objective tool for managing and monitoring surgical site infections after cesarean section, also by photographic evaluation.