Perioperative oral care can prevent surgical site infection after colorectal cancer surgery: A multicenter, retrospective study of 1,926 cases analyzed by propensity score matching
Perioperative oral care can prevent surgical site infection after colorectal cancer surgery: A multicenter, retrospective study of 1,926 cases analyzed by propensity score matching
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DOI：
10.1016/j.surg.2022.02.015
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发表时间：
2022-07-11
期刊：
影响因子：
3.8
通讯作者：
Yamaguchi, Taihei
中科院分区：
文献类型：
--
作者：
Nobuhara, Hiroshi;Matsugu, Yasuhiro;Yamaguchi, Taihei
背景：手术部位感染是结直肠癌手术后常见的并发症，手术部位感染增加了医疗费用，延长了住院时间，恶化了远期预后。据报道，围手术期口腔护理在预防术后肺炎方面是有效的，尽管关于其预防手术部位感染的有效性的报道很少。本研究旨在探讨围手术期口腔护理在预防结直肠癌术后感染中的作用。方法：对来自8个机构的1926例结直肠癌患者进行围手术期口腔护理，其中808例患者(口腔护理组)在医院口腔门诊接受围手术期口腔护理，1118例(对照组)未接受围手术期口腔护理。这些数据与倾向评分相匹配，以减少偏见。结果：口腔护理组手术部位感染发生率显著低于对照组(8.4%比15.7%，P<；.001)。多因素Logistic回归分析显示，手术部位感染有4个独立危险因素：白蛋白水平低、直肠癌、失血和围手术期口腔护理不足。缺乏围手术期口腔护理的优势比为2.100(95%可信区间1.510-2.930，P<；.001)。结论：围手术期口腔护理可以降低结直肠癌切除术后手术部位感染的发生率。作为一种安全有效的预防手术部位感染的方法，围手术期口腔护理可能在未来的结直肠癌围手术期处理中发挥重要作用，尽管还需要在前瞻性研究中进一步验证。(C)2022 Elsevier Inc.保留所有权利。
Background: Surgical site infection is a common postoperative complication of colorectal cancer surgery, and surgical site infection increases medical costs, prolongs hospitalization, and worsens long-term prognosis. Perioperative oral care has been reported to be effective in preventing postoperative pneumonia, although there are only a few reports on its effectiveness in preventing surgical site infection. This study aimed to determine the role of perioperative oral care in surgical site infection prevention after colorectal cancer surgery.Methods: In this study, 1,926 patients with colorectal cancer from 8 institutions were enrolled; 808 patients (oral care group) received perioperative oral care at the hospital's dental clinic, and 1,118 (control group) did not receive perioperative oral care. The data were matched by propensity score to reduce bias. Ultimately, a total of 1,480 patients were included in the analysis.Results: The incidence of surgical site infection was significantly lower in the oral care group than in the control group (8.4% vs 15.7%, P < .001). Multivariate logistic regression analysis revealed 4 independent risk factors for surgical site infection: low albumin level, rectal cancer, blood loss, and lack of perioperative oral care. Lack of perioperative oral care had an odds ratio of 2.100 (95% confidence interval 1.510-2.930, P < .001).Conclusion: These results suggest that perioperative oral care can reduce the incidence of surgical site infection after colorectal cancer resection. Perioperative oral care may have an important role in the future perioperative management of colorectal cancer as a safe and effective method of surgical site infection prevention, although further validation in prospective studies is needed. (C) 2022 Elsevier Inc. All rights reserved.