系统性炎症反应综合征和假肢关节感染
Zachary A McConnell1, Karan M Patel1, Simon C Mears1
1Departments of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
The Journal of arthroplasty
|August 2, 2023
概括
系统性炎症反应综合征 (SIRS) 影响近10%的假肢关节感染 (PJI) 患者,导致更长的住院时间和更高的死亡率. 识别贫血和糖尿病等危险因素可以帮助管理SIRS的PJI患者.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 系统性炎症反应综合征 (SIRS) 标准与增加的死亡率有关.
- 在患有假肢关节感染 (PJI) 的患者中,SIRS的发展和影响尚不清楚.
研究的目的:
- 为了确定PJI患者中SIRS的发病率.
- 在PJI患有SIRS的患者中识别风险因素,临床结果和致病生物.
主要方法:
- 对655名患有部或膝盖PJI的患者进行了回顾性分析.
- 有SIRS警报 (PJI + SIRS) 和没有SIRS警报 (PJI) 的患者之间的比较.
- 对临床结果,并发症和微生物数据的分析.
主要成果:
- 在9.6%的PJI患者中出现SIRS.
- PJI + SIRS与更高的ICU入院率 (27.0%与6.9%相比),更长的住院时间 (7.7与5.6天相比) 和增加的两年重复手术 (36.5%与22.3%) 和死亡率 (17.5%与8.8%) 相关.
- 危险因素包括各种贫血,糖尿病,电解质和神经系统疾病,功能衰竭和胃潰瘍疾病. 黄金葡萄球菌在PJI + SIRS中更常见.
结论:
- 在PJI患者中,SIRS发生率约为10%.
- PJI + SIRS显著增加了不良结果,包括停留时间,ICU入院,重新手术和死亡率.
- 某些并发症有助于对PJI患者发展SIRS的风险进行分层.
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