一个回顾性队列研究术后外科手术部位感染开放尾切除术后:预测因素和风险预测模型的开发和验证
Qasem Alyhari1, Shima'a Marzah2, Hanadi Alsharai3
1Department of General Surgery, School of Medicine, Ibb University of Medical Science, Ibb, YEM.
Cureus
|July 11, 2025
概括
一个新的风险模型准确地预测了开放性尾切除术后的手术部位感染 (SSIs),识别了高风险患者,以便在资源有限的环境中进行有针对性的预防.
科学领域:
- 手术成果研究的研究结果.
- 传染病流行病学 传染病流行病学
- 在资源有限的环境中开展卫生服务研究.
背景情况:
- 手术部位感染 (SSIs) 是开放性尾切除术的重要并发症,特别是在资源有限的地区.
- 缺乏经过验证的风险工具使预防和抗菌药物管理复杂化.
- 在没有先进的腹腔镜技术的情况下,开放性尾切除仍然很常见.
研究的目的:
- 为了确定开放性尾切除术后SSI的患病率.
- 确定SSI的独立风险因素.
- 开发和验证SSI的实际风险预测模型.
主要方法:
- 对245例开放尾切除病例进行了回顾性横截面研究.
- 在手术后30天内使用CDC标准进行SSI监测.
- 多变量后勤回归和ROC分析用于模型开发和验证.
主要成果:
- 总体上,SSI率为13.9%. 这是一个很好的数字.
- 关键预测因素:穿孔性尾炎,症状持续时间>48小时,ASA类≥III,手术时间>60分钟.
- 该模型显示出优异的分辨率 (AUC=0.82) 和良好的校准,将患者分为低,中等和高风险组.
结论:
- 一个经过验证的四变量风险模型有效地分层了开放性尾切除术后SSI风险.
- 该模型对于资源受限的设置非常实用,因为它易于使用,并且依赖常规数据.
- 建议进行进一步的外部验证和临床影响研究.
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