■手术部位感染(SSI),尽管不常见,严重影响护理质量。本文致力于研究在资源有限的情况下,在单个机构中涉及胃肠道(GI)的外科手术干预后,SSI的预测因素。
在2015年6月至2022年6月的7年间,对接受胃肠道手术并发生SSI的患者与未受影响的病例对照队列进行回顾性匹配。伤口培养的标准化技术,细菌分离物的实验室评估,并采用抗生素药敏试验。采用Logistic回归分析探讨与术后30dSSI发生相关的预测因素。
■共纳入525例接受胃肠外科手术的患者,其中,86例(16.4%)发展为SSI,大部分为浅层(74.4%)。大肠杆菌是最常见的细菌(54.4%),观察到高百分比的多药耐药生物(63.8%)。在多元Cox回归分析中,文盲(赔率比[OR]:40.31;95%置信区间[CI]:9.54-170.26),吸烟(OR:21.15;95%CI:4.63-96.67),糖尿病(OR:5.07;95%CI:2.27-11.35),白细胞增多(OR:2.62;95%CI:1.24-5.53),低蛋白血症(OR:3.70;95%CI:1.35-10.16),污染和肮脏的伤口(OR:6.51;95%CI:1.62-26.09),更长的操作持续时间(OR:1.02;95%CI:1.01-1.03),紧急操作(OR:12.58;95%CI:2.91-54.30),延长抗生素预防时间(OR:3.01;95%CI:1.28-7.10)是SSI的独立危险因素(均p<0.05)。
■这项研究强调了SSI的重要预测因素,包括文盲,吸烟,糖尿病,白细胞增多,低蛋白血症,污染和肮脏的伤口,更长的手术时间,紧急行动,并延长抗生素预防持续时间。识别这些危险因素可以帮助外科医生采取适当的措施来减少术后SSI并提高手术护理质量,特别是在资源有限的情况下,没有明显和严格的政策来降低SSI。
UNASSIGNED: Surgical site infection (SSI), albeit infrequent, drastically impacts the quality of care. This article endeavors to investigate the predictive factors of SSIs following surgical interventions that involve the gastrointestinal (GI) tract within a single institution in a resource-limited setting.
UNASSIGNED: Over seven years from June 2015 to June 2022, patients who underwent GI surgery and developed SSI were retrospectively matched with an unaffected case-control cohort of patients. Standardized techniques for wound culture, laboratory evaluation of bacterial isolates, and antibiotic susceptibility tests were employed. Logistic regression analysis was utilized to investigate the predictive factors associated with 30-day postoperative SSI occurrence.
UNASSIGNED: A total of 525 patients who underwent GI surgical procedures were included, among whom, 86 (16.4%) developed SSI and the majority of SSIs were superficial (74.4%). Escherichia coli was the most commonly isolated bacterium (54.4%), and a high percentage of multidrug-resistant organisms were observed (63.8%). In multivariate Cox regression analysis, illiteracy (Odds ratio [OR]:40.31; 95% confidence interval [CI]: 9.54-170.26), smoking (OR: 21.15; 95% CI: 4.63-96.67), diabetes (OR: 5.07; 95% CI: 2.27-11.35), leukocytosis (OR: 2.62; 95% CI: 1.24-5.53), hypoalbuminemia (OR: 3.70; 95% CI: 1.35-10.16), contaminated and dirty wounds (OR: 6.51; 95% CI:1.62-26.09), longer operation duration (OR: 1.02; 95% CI: 1.01-1.03), emergency operations (OR: 12.58; 95% CI: 2.91-54.30), and extending antibiotic prophylaxis duration (OR: 3.01; 95% CI: 1.28-7.10) were the independent risk factors for SSI (all p < 0.05).
UNASSIGNED: This study highlights significant predictors of SSI, including illiteracy, smoking, diabetes, leukocytosis, hypoalbuminemia, contaminated and dirty wounds, longer operative time, emergency operations, and extending antibiotic prophylaxis duration. Identifying these risk factors can help surgeons adopt appropriate measures to reduce postoperative SSI and improve the quality of surgical care, especially in a resource-limited setting with no obvious and strict policy for reducing SSI.