动脉瘤下结出血后的外科手术期感染:危险因素,致病原体和长期结果
Collin B Kilgore1,2, Kathleen R Ran1, Anita L Kalluri1
1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore , Maryland , USA.
Neurosurgery
|September 14, 2023
概括
鼻腔感染在动脉瘤下arachnoid出血 (aSAH) 患者中很常见,影响恢复. 风险因素因感染类型而异,特定的病原体与不良结果相关,需要个性化患者管理.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 神经外科 神经外科
背景情况:
- 鼻腔感染是重症患者经常出现的并发症,导致长期不良后果.
- 患有动脉瘤下关节出血 (aSAH) 的患者面临高风险的术后感染,但影响这些感染和功能恢复的因素仍然不清楚.
研究的目的:
- 为了确定aSAH后的外科手术期间感染的危险因素.
- 为了将致病原体与患者的结果和功能恢复相关联.
主要方法:
- 194名成年aSAH患者 (2016-2020) 的临床记录的回顾性分析.
- 收集的数据包括人口统计,临床过程,并发症,微生物学和结果.
- 统计分析包括千平方,单变量和多变量逻辑回归.
主要成果:
- 近50%的患者患上了医院感染,主要是肺炎和尿路感染.
- 感染与更长的住院时间,延迟大脑缺血症增加和功能恢复较差有关.
- 肺炎的独立风险因素包括男性性别,入院时的昏迷和机械通风;年龄较大和入院时间较长是尿路感染的风险因素.
- 特定的病原体,如葡萄球菌,Klebsiella,和菌种类. 与糟糕的长期结果有关.
结论:
- 术后感染在aSAH患者中非常普遍,并且与不良结果有显著的关联.
- 对于不同类型的感染及其致病生物体,存在不同的风险概况.
- 虽然普遍的感染控制至关重要,但针对特定感染和病原体量身定制的个性化患者管理至关重要.
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