重新评估经验性抗真菌覆盖的必要性在胃口腔腔穿孔
Jordan D Raine1, Meredith G Rippy1, M Victoria P Miles1
1Department of Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA.
The American surgeon
|August 13, 2025
概括
鉴定胃口孔 (GDP) 患者真菌感染的危险因素至关重要. 患有GDP和真菌感染的患者经常出现贫血并需要血管压缩剂,但死亡率相似.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 手术重症监护手术重症监护
背景情况:
- 经验 perioperative 抗真菌覆盖在胃口腔穿孔 (GDP) 具有可疑的好处,并导致不必要的抗真菌暴露.
- 识别患有真菌感染高风险的患者对于有针对性的实证抗真菌疗法至关重要.
研究的目的:
- 确定非创伤性GDP的成年患者发病真菌感染的风险因素.
- 评估实证抗真菌覆盖对GDP患者死亡率,停留时间 (LOS) 和再手术率的潜在益处.
主要方法:
- 在2018年至2024年期间,对被诊断患有非创伤性GDP的成年患者进行了回顾性队列研究.
- 包括标准包括特定的CPT代码 (43631,43632,43840,43659) 和完整的电子病历.
- 分析对比了患有真菌感染的患者与没有患有真菌感染的患者.
主要成果:
- 在151名患者中,19名 (12.6%) 患有培养证明的真菌感染.
- 患有真菌感染的患者使用血管压缩剂的比例更高 (47.4%与22.7%) 和贫血 (血红蛋白10.6g/dL与13.5g/dL).
- 患有真菌感染的患者经历了更长的LOS (23 vs 12天) 并需要更多的手术 (2.53 vs 1.52),在住院死亡率上没有显著差异.
结论:
- 患有真菌感染的非创伤性GDP患者更有可能需要血管压缩剂,并且患有贫血.
- 两组之间在住院死亡率上没有发现显著差异.
- 需要进一步调查以确定最佳的经验性抗真菌剂,考虑到非白类物种的流行.
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