在接受小儿心脏手术的患者中,手术部位感染的危险因素
Anna Christina de Lima Ribeiro1, Rinaldo Focaccia Siciliano2, Antonio Augusto Lopes1
1Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Cardiologia Pediátrica e Cardiopatias Congênitas do Adulto, São Paulo , SP - Brasil.
Arquivos brasileiros de cardiologia
|December 21, 2023
概括
婴儿年龄,遗传综合征和较高的RACHS-1分数增加了儿科心脏手术患者手术部位感染的风险. 手术后的C-反应蛋白水平可能会提供保护.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 传染病流行病学 传染病流行病学
- 临床风险因素分析
背景情况:
- 手术部位感染 (SSI) 是小儿心脏手术后的严重并发症,导致发病率和死亡率增加.
- 确定可修改和不可修改的风险因素对于有效的预防策略至关重要.
研究的目的:
- 在接受儿科心脏手术的患者中,确定与手术部位感染相关的特定风险因素.
- 为制定有针对性的干预措施提供信息,以减少SSI发生率.
主要方法:
- 采用了病例控制研究设计,将SSI患者与匹配的对照进行了比较.
- 数据是从患者病历中追溯收集的,包括手术前,手术内和手术后的变量.
- 用单变量和多变量逻辑回归分析来确定风险因素,统计显著性设置为p<0.05.
主要成果:
- 婴儿年龄 (概率 [OR] 3.19),遗传综合征存在 (OR 6.20) 和较高的RACHS-1类别 (3和4,OR 8.40) 被确定为SSI的显著风险因素.
- 在手术后48小时,C反应蛋白 (CRP) 水平升高被发现是保护因素 (OR 0.85).
结论:
- 在儿科心脏手术中,SSI的主要风险因素,如婴儿年龄和遗传综合征,是不可修改的.
- 术后CRP的保护作用需要进一步研究以了解其机制.
- 加强监测和新的预防策略是必要的,以减轻SSI的发病率.
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