外腔室排水相关感染的危险因素:系统性审查和元分析
Jialei Zhou1, Yi Zhong1, Xiang Li1
1Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University Suzhou, Jiangsu Province, China.
Neurology. Clinical practice
|August 2, 2023
概括
外腔室排水 (EVD) 感染令人担忧,但这次元分析确定了诸如出血,全身感染和导管变化等关键风险因素. 涂银和浸抗生素的导管可以降低感染风险.
科学领域:
- 神经外科 神经外科
- 传染病流行病学 传染病流行病学
- 医疗信息学 医疗信息学
背景情况:
- 外腔室排水 (EVD) 是一种常见的神经外科手术程序.
- 与埃博拉病毒相关的感染对患者安全构成重大威胁.
- 关于埃博拉病毒感染的主要风险因素,存在有限的共识.
研究的目的:
- 系统地审查和综合有关埃博拉病毒相关感染发病率的证据.
- 识别和量化与埃博拉病毒感染发展相关的风险因素.
主要方法:
- 使用来自PubMed,Embase和Cochrane图书馆的数据进行了全面的元分析.
- 包括到2022年2月28日发表的研究,调查埃博拉病毒感染风险因素.
- 聚合赔率比率 (OR) 和95%置信区间 (CI) 使用R.软件计算.
主要成果:
- 确定的显著危险因素包括下arachnoid/心室内出血 (OR=1.48),系统性感染 (OR=1.90),其他神经外科手术 (OR=1.76),导管更换 (OR=5.05),双边EVD (OR=2.25),CSF泄漏 (OR=3.19) 和持续时间>7天 (OR=4.62).
- 涂银 (OR=0.57) 和浸抗生素的导管 (OR=0.60) 显示出降低感染风险的潜力.
- 糖尿病,类固醇使用和预防性抗生素等因素在本分析中没有显示出与埃博拉病毒感染的统计学意义上的关联.
结论:
- 这一元分析提供了一个更清晰的概况,患者的风险更高的EVD相关感染.
- 识别这些风险因素可以为预防策略和患者管理协议提供信息.
- 这些发现支持考虑专用导管以减轻感染风险.
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