Rates and burden of surgical site infections associated with pediatric colorectal surgery: insight from the National Surgery Quality Improvement Program
Rates and burden of surgical site infections associated with pediatric colorectal surgery: insight from the National Surgery Quality Improvement Program
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DOI：
10.1016/j.jpedsurg.2016.02.063
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发表时间：
2016-06-01
影响因子：
2.4
通讯作者：
Rangel, Shawn J.
中科院分区：
文献类型：
--
作者：
Feng, Christina;Sidhwa, Feroze;Rangel, Shawn J.
目的：本研究的目的是描述与儿童结直肠手术相关的手术部位感染（SSI）的发生率，以及这些事件在儿科手术实践范围内的相对负担。方法：查询2012-2013年期间从50家医院捕获的所有儿科手术程序的NSQIP-儿科公共使用文件。率切口和深器官/空间SSI（ISSI和OSI，分别）计算所有程序，并从整个数据集归因于结直肠procedures的SSI的相对负担determined.Results：结直肠程序占2.5%（2872/114，395）的NSQIP-P的病例量，并贡献了7.1%的SSI负担。所有结直肠手术的SSI发生率为5.9%（ISSI：3.2%; OSI：2.7%），发生率最高的是全腹结肠切除术（11.4%）、部分结肠切除术（8.3%）和结肠造口闭合术（5.0%）。在结直肠诊断中，炎症性肠道疾病对SSI的相对负担最大（24.9%; ISSI：22%; OSI：28.6%），其次是先天性巨结肠（14.2%; ISSI：15.4%; OSI：12.8%）和肛门直肠畸形（12.4%; ISSI：17.6%; OSI：6.4%）。结论：结直肠手术是儿科手术中SSI负担不成比例的原因。对于结肠造口闭合、部分结肠切除术和炎症性肠病手术，SSI的发生率和相对负担特别高。减少SSI负担的努力可能最好集中在这一组儿童身上。(C)2016 Elsevier Inc. All rights reserved.
Purpose: The purpose of this study was to characterize the rates of surgical site infections (SSI) associated with colorectal procedures in children and the relative burden of these eventswithin the scope of pediatric surgical practice.Methods: The NSQIP-Pediatric Public Use Filewas queried for all pediatric surgery procedures captured from50 hospitals during 2012-2013. Rates of incisional and deep organ/space SSIs (ISSI and OSI, respectively) were calculated for all procedures, and the relative burden of SSIs from the entire dataset attributable to colorectal procedures was determined.Results: Colorectal procedures accounted for 2.5% (2872/114,395) of the NSQIP-P caseload and contributed 7.1% of the SSI burden. The SSI rate for all colorectal procedures was 5.9% (ISSI: 3.2%; OSI: 2.7%), and the highest rates were associatedwith total abdominal colectomy (11.4%) partial colectomy (8.3%), and colostomy closure (5.0%). Inflammatory bowel disease contributed the greatest relative burden of SSIs among colorectal diagnoses (24.9%; ISSI: 22%; OSI: 28.6%), followed by Hirschsprung's Disease (14.2%; ISSI: 15.4%; OSI: 12.8%) and anorectal malformations (12.4%; ISSI: 17.6%; OSI: 6.4%).Conclusion: Colorectal procedures are responsible for a disproportionate burden of SSIs within pediatric surgery. The rate and relative burden of SSIs are particularly high for colostomy closure, partial colectomy, and procedures for inflammatory bowel disease. Efforts to reduce SSI burden may be best focused on this cohort of children. (C) 2016 Elsevier Inc. All rights reserved.