在区域质量协作中对深胸部伤口感染的时间群分析
Andrew D Hawkins1, Erik J Scott1, Jeison De Guzman1
1Division of Cardiac Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia.
The Journal of surgical research
|June 23, 2023
概括
深胸部伤口感染 (DSWI) 是罕见但严重的. 这项研究没有发现DSWI的季节性模式,尽管随着时间的推移,率下降,并因医院而异.
科学领域:
- 心血管外科心血管外科
- 传染病流行病学 传染病流行病学
- 公共卫生 公共卫生
背景情况:
- 深胸部伤口感染 (DSWI) 是心脏手术后的一种罕见但严重的并发症,死亡率很高.
- 虽然已经记录了手术部位感染的季节性变化,但对于DSWI,这种模式尚未确定.
- 了解DSWI的时间趋势对于资源配置和感染控制策略至关重要.
研究的目的:
- 调查心脏手术患者的深部伤口感染 (DSWI) 的时间聚类和季节性变异性.
- 分析不同时间间隔的医院和区域级别的DSWI发病率.
- 识别任何季节性或年度模式,可以为预防措施提供信息.
主要方法:
- 在17个中心对134,959名心脏手术患者进行了回顾性分析,这些患者在2001年至2019年间接受了胸腔切除术.
- 鉴定了469名被诊断为DSWI的患者,并对每月,每季度和每年数据进行了集群分析.
- 使用混合效应负二项式回归来评估时间趋势和变化的DSWI率的统计比较.
主要成果:
- DSWI发生在0.35%的患者中,病例在各医院的比例在0.12%至0.69%之间.
- 没有观察到DSWI的显著季节性聚类;9月份的比例最高 (0.44%),1月份最低 (0.30%).
- 从2001年到2019年,DSWI率出现了显著的下降趋势 (P < 0.001),有显著的医院间变化 (P < 0.001).
结论:
- 在研究区域内,深胸部伤口感染并不常见.
- 与其他手术部位感染不同,DSWI没有明显的季节性模式.
- 随着时间的推移,DSWI的发病率有所下降,但医疗机构之间存在显著差异.
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