周围假肢关节感染和并发性败血症:揭示临床表现,危险因素和患者结果
Susanne Baertl1, David Lovasz2, Martin G Kees3
1Regensburg University Medical Center, Department of Trauma Surgery, Regensburg, Germany.
The Journal of arthroplasty
|December 21, 2024
概括
周围假肢关节感染 (PJIs) 经常导致败血症,增加死亡率和住院时间. 早期检测和干预对于管理这种危及生命的并发症至关重要.
科学领域:
- 整形外科 整形外科 整形外科
- 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:
- 周围假肢关节感染 (PJI) 是关节和膝关节置换手术后的一种严重并发症.
- 败血症是一种危及生命的器官功能障碍,是由宿主对感染反应失调引起的,可以从PJIs中产生.
研究的目的:
- 调查部和膝盖周围假肢关节感染 (PJIs) 患者的流行病学,风险因素和败血症的结果.
主要方法:
- 败血症诊断使用了败血症-1标准.
- 一组患有PJI和败血症的患者与仅患有PJI的患者进行了比较.
- 分析了风险因素 (患者特征,微生物学,并发症) 和结果 (死亡率,住院/ICU).
主要成果:
- 在108个PJI中,有40.6%符合败血症标准. 部PJI与败血症显示较高的并发病率 (CCI 4.0对1.0) 和黄金葡萄球菌流行率. 脏和心脏疾病增加了败血症的风险.
- 患有败血症的膝盖PJI也具有更高的S.金色菌率. 心房动和脏疾病与败血症有关. 败血症病例经历了更长的住院时间和更高的ICU入院率.
- 在部 (23.5%对3.2%) 和膝盖 (25.0%对3.3%) PJIs中,入院死亡率在败血症队列中显著更高.
结论:
- 很大一部分PJI发展为败血症,导致死亡率大幅增加.
- 密切监测患者至关重要,以便及时发现病情恶化的情况.
- 及时的,类似于败血症的干预措施对于降低PJI患者的发病率和死亡率至关重要.
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