Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review.
Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review.
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DOI：
10.1089/sur.2017.089
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发表时间：
2017
影响因子：
2
通讯作者：
Hinoul P
中科院分区：
文献类型：
--
作者：
Cheng H;Chen BP;Soleas IM;Ferko NC;Cameron CG;Hinoul P
背景：据报道，手术部位感染(SSI)的发生率在不同的手术程序、专业和条件下从0.1%到50%不等。手术持续时间经常被认为是SSI的一个独立的和潜在的可改变的危险因素。这项系统回顾的目的是深入了解手术时间和SSI之间的关系。患者和方法：本综述包括81项前瞻性和回溯性研究。随着研究设计的进行，提取SSI的可能性、平均手术时间、时间阈值、效果度量、可信区间和p值。进行了三项荟萃分析，优势比按每小时手术时间阈值、手术时间增加的增量和手术专业合并。结果：综合分析表明，延长的手术时间和SSI之间的相关性通常在统计学上仍然显著，在不同的时间阈值下观察到SSI的可能性接近两倍。SSI的可能性随着时间的增加而增加；例如，每手术15分钟、30分钟和60分钟，SSI的可能性分别增加13%、17%和37%。平均而言，在不同的手术过程中，SSIS患者的平均手术时间比没有SSIS的患者长约30分钟。结论：延长手术时间可增加SSI的风险。考虑到SSI对患者预后和医疗经济的重要性，医院应该集中精力减少手术时间。
Background: The incidence of surgical site infection (SSI) across surgical procedures, specialties, and conditions is reported to vary from 0.1% to 50%. Operative duration is often cited as an independent and potentially modifiable risk factor for SSI. The objective of this systematic review was to provide an in-depth understanding of the relation between operating time and SSI. Patients and Methods: This review included 81 prospective and retrospective studies. Along with study design, likelihood of SSI, mean operative times, time thresholds, effect measures, confidence intervals, and p values were extracted. Three meta-analyses were conducted, whereby odds ratios were pooled by hourly operative time thresholds, increments of increasing operative time, and surgical specialty. Results: Pooled analyses demonstrated that the association between extended operative time and SSI typically remained statistically significant, with close to twice the likelihood of SSI observed across various time thresholds. The likelihood of SSI increased with increasing time increments; for example, a 13%, 17%, and 37% increased likelihood for every 15 min, 30 min, and 60 min of surgery, respectively. On average, across various procedures, the mean operative time was approximately 30 min longer in patients with SSIs compared with those patients without. Conclusions: Prolonged operative time can increase the risk of SSI. Given the importance of SSIs on patient outcomes and health care economics, hospitals should focus efforts to reduce operative time.
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DOI：
10.1016/j.injury.2012.10.032
发表时间：
2013-02
影响因子：
2.5
作者：
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DOI：
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发表时间：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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