目的:手术部位感染(SSIs)是手术后发现的重要并发症之一。最近的研究强调了抗菌药物,伤口愈合,以及维生素D的免疫学特性。因此,本研究调查了沙特阿拉伯患者术前维生素D水平与SSI发生之间的关系.
方法:我们在费萨尔国王医疗中心接受手术的患者中进行了这项回顾性观察研究,沙特阿拉伯。我们纳入了2021年1月至2023年10月期间接受手术的患者的数据。如果入院时没有测量维生素D浓度,患者被排除在最终分析之外.研究人员使用计算机程序社会科学统计软件包(SPSS)进行统计分析,版本26.0(IBMCorp.,Armonk,NY).当p值小于0.05时,认为显著水平。
结果:该研究包括130名患者,平均(SD)年龄为26.98(9.3)岁。大多数患者为女性(n=92,70.8%),患有糖尿病(n=121,93.1%),维生素D缺乏(<30ng/dl)(n=106,81.5%),并进行了剖宫产(n=80,61.5%)。患者的平均(SD)维生素D水平为19.9(9.7)ng/dl,平均(SD)血红蛋白水平几乎正常(12.30(2.1)g/dl)。在40.8%(n=53)的患者中,检出最多的致病菌是大肠杆菌,其次是金黄色葡萄球菌(n=11,44%,n=7,25%,分别)。此外,维生素D缺乏显著影响SSI阳性;与水平足够的患者相比,水平不足的患者感染率更高(n=58,54.7%vs.n=7,29.2%,p值=0.024)。较长的手术时间不会增加SSI的风险(p值=0.047)。3级伤口的患者比2级伤口的患者更容易发生SSI(n=12,100%vs.n=53,44.9%,p值<0.001)。
结论:这项研究提供了支持维生素D缺乏与SSI发生率之间关系的重要证据。维生素D水平较低的患者报告了较高的SSIs发生率。医疗保健提供者应注意接受手术的患者中维生素D缺乏的高患病率。筛查维生素D缺乏症并实施便利的干预措施以优化维生素D水平可能有助于降低SSIs的发生率。用更大的样本量进一步研究,更多样化的人口,和不同的手术类型是必要的,以验证这些发现,并探讨影响SSI发展的其他因素。
OBJECTIVE: Surgical site infections (SSIs) are one of the significant complications detected after surgical procedures. Recent studies have highlighted the antimicrobial, wound-healing, and immunological properties of vitamin D. Therefore, this study examined the association between levels of preoperative vitamin D and SSI occurrence in Saudi Arabia.
METHODS: We conducted this retrospective observational study among patients who underwent surgery at King Faisal Medical Complex, Saudi Arabia. We included data from patients who underwent surgery between January 2021 and October 2023 in the study. If vitamin D concentrations were not measured at admission, patients were excluded from the final analysis. The researchers performed statistical analysis using the computer program Statistical Package for Social Sciences (SPSS), version 26.0 (IBM Corp., Armonk, NY). The significant level was considered when the p-value was less than 0.05.
RESULTS: The study included 130 patients with a mean (SD) age of 26.98 (9.3) years. Most patients were females (n = 92, 70.8%), had diabetes mellitus disease (n = 121, 93.1%), had a vitamin D deficiency (<30 ng/dl) (n = 106, 81.5%), and underwent cesarean section (n = 80, 61.5%). The mean (SD) vitamin D level among patients was 19.9 (9.7) ng/dl, and the mean (SD) hemoglobin level was almost normal (12.30 (2.1) g/dl). Out of 40.8% (n = 53) of patients, the most detected pathogenic bacteria was Escherichia coli, followed by Staphylococcus aureus (n = 11, 44%, and n = 7, 25%, respectively). Furthermore, vitamin D deficiency significantly impacted positive SSI; patients with insufficient levels had a higher infection rate compared to those with sufficient levels (n = 58, 54.7% vs. n = 7, 29.2%, p-value = 0.024). A longer surgery duration did not increase the risk of SSI (p-value = 0.047). Patients with class 3 wounds were more prone to SSI than those with class 2 wounds (n = 12, 100% vs. n = 53, 44.9%, p-value<0.001).
CONCLUSIONS: This study provides important evidence supporting the relationship between vitamin D deficiency and SSI incidence. Patients with lower levels of vitamin D reported a higher incidence of SSIs. Healthcare providers should pay attention to the high prevalence of vitamin D deficiency among patients undergoing surgery. Screening for vitamin D deficiency and implementing convenient interventions to optimize vitamin D levels could help reduce the incidence of SSIs. Further research with larger sample sizes, more diverse populations, and different surgery types is necessary to validate these findings and explore additional factors influencing SSI development.