作为创伤后风险因素的医院感染:基于注册表的队列研究
Zhibin Chen1,2,3,4, Joshua Laing1,5,6, Jian Li7
1Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Epilepsia open
|May 10, 2024
概括
中度至重度创伤性脑损伤 (TBI) 患者在医院获得的感染增加了患创伤后 (PTE) 的风险. 预防这些感染可能会改善TBI幸存者的结果.
科学领域:
- 神经科学是一个神经科学.
- 传染性疾病 传染性疾病
- 创伤外科 手术 创伤外科
背景情况:
- 住院感染 (HAI) 是中度至重度创伤性脑损伤 (TBI) 患者的重要并发症.
- 感染介导的免疫反应与的病变发生有关.
- 医疗卫生感染和创伤后 (PTE) 的发展之间的联系需要进一步调查.
研究的目的:
- 调查医院获得的感染增加中度至重度TBI患者创伤后 (PTE) 的风险的假设.
- 探索HAI和PTE发展之间的关联.
- 检查HAI对TBI后更广泛的患者结局的影响.
主要方法:
- 使用澳大利亚维多利亚州创伤登记处进行的回顾性队列研究.
- 包括中度至重度TBI的成年患者.
- 通过ICD-10-AM代码识别感染,并在24个月后通过扩展格拉斯哥结果表 (GOSE) 诊断PTE.
主要成果:
- 24%的TBI患者至少有一次感染,最常见的是肺炎和尿路感染.
- 11%的患者在受伤后24个月内出现PTE.
- 多变量分析显示,任何感染与PTE (调整后的RR=1.59,p=0.011),以及更差的GOSE结果 (调整后的OR=0.20,p<0.001) 之间存在显著的关联.
结论:
- 医院获得的感染是TBI后发展创伤后的重要危险因素.
- 预防TBI患者的HAI可能是减少PTE发病率和改善整体结果的关键可修改目标.
- 需要进一步的研究来探索旨在减轻TBI护理中感染相关并发症的干预措施.
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