在重症监护中的重创患者手术部位感染:流行病学和风险因素
Lucie Savio1,2, Pierre Simeone3,4, Sophie Baron5
1Département d'Anesthésie-Réanimation - Marseille, Université Aix-Marseille, CHU Timone, Marseille, France.
Annals of intensive care
|September 1, 2024
概括
严重创伤患者的手术部位感染 (SSI) 率很高,但这些感染不会影响长期生存. 通过改善术后护理和血液管理策略,可以管理SSI的可修改风险因素.
科学领域:
- 创伤外科 手术 创伤外科
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 严重的创伤是年轻人死亡和残疾的主要原因.
- 手术部位感染 (SSI) 是严重创伤患者的重要并发症.
- 不充分调查SSI可能会对患者的治疗结果产生负面影响.
研究的目的:
- 研究严重创伤患者SSI的流行病学.
- 识别与SSI发展相关的风险因素.
- 评估SSI对48个月生存时间的影响.
主要方法:
- 对重创患者 (STP) 进入重症监护室的多中心回顾性队列研究.
- 包括在入院5天内接受骨科或脊椎手术的患者.
- 诊断SSI是基于CDC的国际诊断标准.
主要成果:
- 23%的STP患有SSI;在SSI和非SSI组之间,48个月死亡率没有差异.
- 造成SSI的危险因素包括血红蛋白低,高乳糖血,高肌素/血糖,以及考斯3级骨折.
- 多微生物感染很常见,主要涉及格拉姆阳性菌.
结论:
- 在严重创伤患者中观察到SSI的高发病率.
- SSI没有显著影响48个月死亡率.
- 加强术后监测和患者血液管理可以减轻可修改的SSI风险因素.
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