退院后手术部位感染的风险因素和监测:前性分析
Esma Eryilmaz Eren1, Zeynep Ture2, Aysegul Ulu Kilic3
1Department of Infectious Disease and Clinical Microbiology, University of Health Sciences, 38080 Kayseri, Türkiye; Department of Clinical Bacteriology and Infectious Diseases, Preventing Hospital Infections Doctorate Programme, Institute of Health Sciences, Erciyes University, 38260 Kayseri, Türkiye.
概括
外科手术部位感染 (SSI) 的出院后监测发现的感染比标准方法多了3.3%. 专注于高风险患者的监测,如糖尿病患者,是检测出院后SSI的更可行的策略.
科学领域:
- 手术部位感染 手术部位感染
- 感染的监测感染的监测.
- 公共卫生 公共卫生
背景情况:
- 针对手术部位感染 (SSI) 的标准医院监测在检测出院后SSI (PD-SSI) 方面存在局限性.
- 关于PD-SSI在各种手术过程中的发病率和风险因素的数据有限.
- 有效的监测策略对于改善患者的治疗结果和减少医疗保健负担至关重要.
研究的目的:
- 为了确定与PD-SSI相关的风险因素.
- 在接受特定选择性手术的患者中检测PD-SSI.
- 为了比较释放后监测的有效性与SSI检测的标准监测方法.
主要方法:
- 一项前性研究包括1232名接受剖腹产,腹腔镜胆囊切除,全膝关节置换 (TKR),腰椎间盘椎手术 (LDHS),冠状动脉旁路移植 (CABG),全部置换 (THR) 或胃切除的患者.
- 收集的数据包括患者人口统计学,并发症,抗生素预防和标准SSI监测状态.
- 通过调查与病人在出院后联系,以识别PD-SSI,独立于感染控制记录.
主要成果:
- 总体上,SSI发生率为9.8% (121/1232). 标准监测检测到6.4% (80/1232) 的SSI,而释放后的调查发现了另外3.3% (41/1232) 的PD-SSI.
- 确定的PD-SSI风险因素包括剖腹产的BMI,腹腔镜胆囊切除术的慢性病,TKR和LDHS的糖尿病,TKR的尿导管持续时间和CABG的高BMI.
- 糖尿病成为一个重要的风险因素,与现有的文献相一致.
结论:
- 出院后的监测显著增加了手术部位感染的检测率.
- 对患有已确定的风险因素的患者实施有针对性的出院后监测是一个比普遍监测更可行和更有效的策略.
- 进一步研究PD-SSI的风险分层是有必要的,以优化感染控制工作.
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