Colon surgical-site infections and the impact of "present at the time of surgery (PATOS)" in a large network of community hospitals.
Colon surgical-site infections and the impact of "present at the time of surgery (PATOS)" in a large network of community hospitals.
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DOI：
10.1017/ice.2022.236
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发表时间：
2023-08
影响因子：
4.5
通讯作者：
Anderson, Deverick J.
中科院分区：
文献类型：
--
作者：
Seidelman, Jessica L.;Ge, Maojun;Baker, Arthur W.;Lewis, Sarah;Advani, Sonali D.;Smith, Becky;Anderson, Deverick J.
描述复杂结肠手术（COLO）的流行病学，按手术时（PATOS）手术部位感染（ssi）和非PATOS ssi分层及其对结肠手术ssi流行病学的影响。回顾性队列研究。SSI数据前瞻性地收集了2015年1月至2019年6月在美国东南部34家社区医院接受国家医疗安全网络（NHSN）定义的结肠外科手术（colo）的患者。Logistic回归模型确定了复杂COLO ssi、复杂非PATOS COLO ssi和复杂PATOS COLO ssi的具体特征。在4.5年的研究期间，我们在28,188例COLO手术后发现了720例复杂的COLO ssi（患病率为2.55 / 100例）。总体而言，544例复杂COLO ssi（76%）为复杂非PATOS COLO ssi（患病率[PR]， 1.93 / 100例），176例（24%）为复杂PATOS COLO ssi（患病率，0.62 / 100例）。年龄bbbb75岁和手术时间bbbb75百分位数与非PATOS ssi独立相关，但与PATOS ssi无关。相反，COLO手术的急诊手术和医院容量与PATOS ssi独立相关，但与非PATOS ssi无关。与PATOS ssi相比，非PATOS ssi的多微生物ssi比例显著高于PATOS ssi。复杂的PATOS COLO ssi与复杂的非PATOS COLO ssi具有不同的特性。从公开报告中删除PATOS COLO ssi可以更准确地比较执行不同结肠手术病例组合的医院。
To describe the epidemiology of complex colon surgical procedures (COLO), stratified by present at time of surgery (PATOS) surgical-site infections (SSIs) and non-PATOS SSIs and their impact on the epidemiology of colon-surgery SSIs. Retrospective cohort study. SSI data were prospectively collected from patients undergoing colon surgical procedures (COLOs) as defined by the National Healthcare Safety Network (NHSN) at 34 community hospitals in the southeastern United States from January 2015 to June 2019. Logistic regression models identified specific characteristics of complex COLO SSIs, complex non-PATOS COLO SSIs, and complex PATOS COLO SSIs. Over the 4.5-year study period, we identified 720 complex COLO SSIs following 28,188 COLO surgeries (prevalence rate, 2.55 per 100 procedures). Overall, 544 complex COLO SSIs (76%) were complex non-PATOS COLO SSIs (prevalence rate [PR], 1.93 per 100 procedures) and 176 (24%) complex PATOS COLO SSIs (PR, 0.62 per 100 procedures). Age >75 years and operation duration in the >75th percentile were independently associated with non-PATOS SSIs but not PATOS SSIs. Conversely, emergency surgery and hospital volume for COLO procedures were independently associated with PATOS SSIs but not non-PATOS SSIs. The proportion of polymicrobial SSIs was significantly higher for non-PATOS SSIs compared with PATOS SSIs. Complex PATOS COLO SSIs have distinct features from complex non-PATOS COLO SSIs. Removal of PATOS COLO SSIs from public reporting allows more accurate comparisons among hospitals that perform different case mixes of colon surgeries.
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影响因子：
9
作者：
Tang, RP;Chen, HH;Wang, JY
通讯作者：
Wang, JY
DOI：
10.1056/nejmoa1306801
发表时间：
2014-03-27
期刊：
The New England journal of medicine
影响因子：
--
作者：
Magill SS;Edwards JR;Bamberg W;Beldavs ZG;Dumyati G;Kainer MA;Lynfield R;Maloney M;McAllister-Hollod L;Nadle J;Ray SM;Thompson DL;Wilson LE;Fridkin SK;Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team
通讯作者：
Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team
影响因子：
2.6
作者：
Kobayashi, Minako;Mohri, Yasuhiko;Kusunoki, Masato
通讯作者：
Kusunoki, Masato
影响因子：
4.9
作者：
通讯作者：
--
影响因子：
4.5
作者：
Kaye, Keith S.;Engemann, John J.;Sexton, Daniel J.
通讯作者：
Sexton, Daniel J.