Analysis of surgical site infection after musculoskeletal tumor surgery: risk assessment using a new scoring system.
Analysis of surgical site infection after musculoskeletal tumor surgery: risk assessment using a new scoring system.
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作者：
Nagano S;Yokouchi M;Setoguchi T;Sasaki H;Shimada H;Kawamura I;Ishidou Y;Kamizono J;Yamamoto T;Kawamura H;Komiya S
手术部位感染（SSI）尚未在肌肉骨骼肿瘤（MST）中进行广泛研究，因为这种疾病很少见。我们分析了MST中SSI的发生率和危险因素。在我们机构治疗的连续457例MST病例（良性，310例，恶性，147例）中评价了SSI发生率。对恶性MST病例的患者临床背景、术前和术后血液学数据以及可能与SSI发生率相关的其他因素进行了详细分析。SSI发生率分别为0.32%和12.2%。SSI组的手术持续时间（P = 0.0002）和术中失血量（P = 0.0005）显著多于非SSI组。我们通过结合4个风险因素（失血量、手术持续时间、术前化疗和人工材料的使用）建立了肌肉骨骼肿瘤手术侵袭性（MOSI）指数。MOSI指数（0-4分）评分与SSI风险显著相关，高分（3-4分）组SSI发生率为38.5%。术后1周的MOSI指数评分和实验室检查有助于SSI的风险评估和早期诊断。
Surgical site infection (SSI) has not been extensively studied in musculoskeletal tumors (MST) owing to the rarity of the disease. We analyzed incidence and risk factors of SSI in MST. SSI incidence was evaluated in consecutive 457 MST cases (benign, 310 cases and malignant, 147 cases) treated at our institution. A detailed analysis of the clinical background of the patients, pre- and postoperative hematological data, and other factors that might be associated with SSI incidence was performed for malignant MST cases. SSI occurred in 0.32% and 12.2% of benign and malignant MST cases, respectively. The duration of the surgery (P = 0.0002) and intraoperative blood loss (P = 0.0005) was significantly more in the SSI group than in the non-SSI group. We established the musculoskeletal oncological surgery invasiveness (MOSI) index by combining 4 risk factors (blood loss, operation duration, preoperative chemotherapy, and the use of artificial materials). The MOSI index (0–4 points) score significantly correlated with the risk of SSI, as demonstrated by an SSI incidence of 38.5% in the group with a high score (3-4 points). The MOSI index score and laboratory data at 1 week after surgery could facilitate risk evaluation and prompt diagnosis of SSI.