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一个临床预测模型,用于预测手术部位感染后,一个开放的减少和内部固定程序考虑NHSN/SIR风险模型:一个多中心病例控制研究

Niloufar Taherpour^1,2, Yadollah Mehrabi², Arash Seifi³

¹Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Frontiers in surgery

|October 6, 2023

概括

在开放式缩小和内部固定 (ORIF) 手术后,手术部位感染 (SSI) 是常见的. 老年,长时间的手术和高血糖是危险因素,而更高的血红蛋白是保护性的.

科学领域:

传染性疾病传染性疾病
外科手术的结果
公共卫生公共卫生

背景情况:

手术部位感染 (SSI) 是一个重要的全球性并发症,特别是在发展中国家,导致死亡率和医疗保健成本增加.
开放的减少和内部固定 (ORIF) 程序容易受到SSI的影响,需要有效的风险分层和预防策略.

研究的目的:

为了确定与手术部位感染 (SSI) 相关的关键风险因素,在开放式缩小和内部固定 (ORIF) 手术后.
开发和验证ORIF患者SSI的预测模型,以帮助早期检测和干预.

主要方法:

一项基于医院的病例控制研究,涉及244名接受ORIF手术的患者 (122例SSI病例,122例对照).
使用后勤回归分析来确定重要的风险因素,并使用歧视和校准指数评估预测模型.
第二次分析估计了ORIF程序中SSI的标准化感染率 (SIR).

主要成果:

在ORIF之后,Klebsiella是最常见的病原体 (14.75%) 导致SSI.
严重的SSI风险因素包括晚年,选择性手术,长时间的手术,ASA分数≥2,伤口类别3-4和手术前葡萄糖>200 mg/dL.
较高的手术前血红蛋白水平显示出对SSI的保护作用. 预测模型显示出强的性能 (AUC 95%).

结论:

该研究确定了预测ORIF患者SSI的关键因素,使得有针对性的预防工作成为可能.
实施风险预测模型可以通过在手术前识别高风险个体来增强医院感染控制计划.
医生可以利用这些发现来主动管理ORIF手术后患有SSI风险增加的患者.

关键词:

这是一次ORIF手术.医院内感染的疾病.预测模型预测模型标准化感染比率是标准化的感染比率.手术部位感染的感染.

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