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在门诊外科手术后的手术部位感染
Pamela L Owens1, Marguerite L Barrett2, Susan Raetzman3
1Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland.
JAMA
|February 20, 2014
概括
门诊手术后临床显著的手术部位感染 (CS-SSIs) 是罕见的,但代表了大量的不良事件. 质量改善举措对于减少这些严重感染至关重要.
科学领域:
- 手术成果研究的研究结果.
- 传染病流行病学 传染病流行病学
- 医疗服务研究 医疗服务研究
背景情况:
- 手术部位感染 (SSI) 是住院患者发病的一个重要原因.
- 门诊手术后严重感染的数据有限.
- 了解门诊外科手术中CS-SSI率对于患者安全至关重要.
研究的目的:
- 为了确定临床显著的手术部位感染 (CS-SSIs) 在低至中度风险的门诊手术后的发病率.
- 在一个庞大,多样化的患者群体中,确定CS-SSIs的术后急症护理访问率.
主要方法:
- 2010年对美国8个州284,098项门诊外科手术的回顾性分析.
- 包括接受整体手术,骨科,神经外科,妇科或泌尿外科手术的具有较低外科风险的成年患者.
- 对CS-SSIs进行14日和30天的术后急症护理访问的评估.
主要成果:
- 需要急性护理访问的CS-SSIs的发病率是14天后每1000次手术3.09,30天后每1000次手术4.84.
- 三分之二的CS-SSI访问发生在14天内,93.2%需要住院治疗.
- 整体术后急性护理访问 (包括CS-SSI) 是19.99 / 1000在14天和33.62 / 1000在30天.
结论:
- 虽然门诊手术后CS-SSI的发病率较低,但它们构成了大量不良结果的总和.
- 这些严重的感染需要集中质量改善工作.
- 在门诊手术中最大限度地减少CS-SSIs对于提高患者安全和结果至关重要.
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