Risk factors for surgical wound infection and bacteraemia following coronary artery bypass surgery.
Risk factors for surgical wound infection and bacteraemia following coronary artery bypass surgery.
复制标题
冠状动脉搭桥手术后手术伤口感染和菌血症的危险因素。
DOI：
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发表时间：
2000
期刊：
影响因子：
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通讯作者：
D. Esmore
中科院分区：
文献类型：
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作者：
D. Spelman;P. Russo;G. Harrington;B. Davis;M. Rabinov;J. Smith;W. Spicer;D. Esmore
背景
对于接受冠状动脉旁路移植术（CABG）手术的患者的手术伤口感染（SWI）和术后菌血症的风险因素，既往研究尚未达成共识。
方法
前瞻性收集了12个月内接受CABG手术的所有患者的15个潜在风险因素的数据。
结果
在693名患者中，62名使用疾病控制中心的定义发展了65 SWI：23名为胸骨伤口感染，42名为导管采集部位的手臂或腿部伤口感染。有19次术后菌血症发作。多变量分析显示：（i）糖尿病、肥胖和既往心血管手术是SWI的独立预测因素;（ii）肥胖是术后菌血症的独立危险因素。
结论
这些结果表明，改善糖尿病控制和术前体重减轻可能会导致SWI的发生率降低。但需要进行进一步的前瞻性研究来检查（i）糖尿病的SWI风险是否会增加，无论是需要胰岛素的糖尿病还是不需要胰岛素的糖尿病，以及改善围手术期糖尿病控制是否会降低SWI;以及（ii）肥胖程度如何会导致SWI和术后菌血症的风险，以及如果在该患者组中是现实的策略，导致SWI降低。
BACKGROUND
There has been no consensus from previous studies of risk factors for surgical wound infections (SWI) and postoperative bacteraemia for patients undergoing coronary artery bypass graft (CABG) surgery.
METHODS
Data on 15 potential risk factors were prospectively collected on all patients undergoing CABG surgery during a 12-month period.
RESULTS
Of 693 patients, 62 developed 65 SWI using the Centres for Disease Control definition: 23 were sternal wound infections and 42 were arm or leg wound infections at the site of conduit harvest. There were 19 episodes of postoperative bacteraemia. Multivariate analysis revealed that: (i) diabetes, obesity and previous cardiovascular procedure were independent predictors of SWI; and (ii) obesity was an independent risk factor for postoperative bacteraemia.
CONCLUSIONS
These findings suggest that improved diabetic control and pre-operative weight reduction may result in a decrease in the incidence of SWI. But further prospective studies need to be undertaken to examine (i) whether the increased SWI risk in diabetes occurs with both insulin- and non-insulin-requiring diabetes, and whether improved peri-operative diabetes control decreases SWI; and (ii) what degree of obesity confers a risk of SWI and postoperative bacteraemia, and whether pre-operative weight reduction, if a realistic strategy in this patient group, results in a decrease in SWI.