中部胸腔切除术后胸伤口感染的危险因素:一个嵌套病例对照研究和时间到事件分析
Xiaolong Ma1, Dongsheng Chen2, Jianchao Liu1
1Institute of Hospital Management, Department of Innovative Medical Research, Chinese PLA General Hospital, Beijing, China.
International wound journal
|July 12, 2024
概括
确定了部伤口感染 (SWI) 风险因素,如BMI,糖尿病 (DM) 和心肌梗塞 (MI). 深度SWI与表面SWI相比,具有较长的发病时间和明显的风险因素.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 医疗信息学 医疗信息学
背景情况:
- 骨伤口感染 (SWI) 是中骨切除术后的一种严重并发症.
- 虽然SWI的风险因素已知,但表面性SWI (SSWI) 和深度SWI (DSWI) 的发病时间和不同的贡献者仍然不太清楚.
研究的目的:
- 为了比较发病时间,并确定表面和深层SWI的不同风险因素.
- 开发一个SWI风险的预测模型.
主要方法:
- 一个嵌套的病例控制研究,涉及成人患者接受心脏手术通过中枢骨切除.
- 分析包括卡普兰-梅尔,LASSO和考克斯回归模型.
- 为SWI风险预测开发了一个名图.
主要成果:
- SWI的发生率为1.1%. SWI的中位发病时间为35天,DSWI的延迟时间比SSWI (32天) 长 (46天).
- 整体SWI的独立风险因素包括BMI,糖尿病 (DM) 和心肌梗塞 (MI).
- SSWI与BMI有关,而DSWI与DM和更长的手术持续时间有关. 在SWI预测名录显示了公平的表现 (AUC 0.67).
结论:
- BMI,DM和MI是心脏手术后SWI的重要独立风险因素.
- 表面和深层SWI表现出不同的发病时间和相关的风险因素,需要定制的管理策略.
- 开发的诺米图为临床预测SWI风险提供了一个有用的工具.
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