Risk factors for endometritis after low transverse cesarean delivery.
Risk factors for endometritis after low transverse cesarean delivery.
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DOI：
10.1086/649018
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发表时间：
2010-01
影响因子：
4.5
通讯作者：
Fraser VJ
中科院分区：
文献类型：
--
作者：
Olsen MA;Butler AM;Willers DM;Gross GA;Devkota P;Fraser VJ
探讨低位横切剖宫产术后子宫内膜炎（EMM）的独立危险因素。我们于1999年7月至2001年6月在一家大型三级医疗学术医院进行了回顾性病例对照研究。EMM定义为在无其他发热原因的情况下，分娩后24小时开始发热或持续发热≥24小时，并伴有足底压痛。通过多变量logistic回归确定EMM的独立危险因素。一个分数多项式方法被用来检查与连续变量相关的EMM风险，膜破裂的持续时间。124/1605例（7.7%）女性在LTCS后30天内发现EMM。EMM的独立危险因素包括年龄(每增加一年的优势比（OR）为0.93；95%可信区间（CI）： 0.90-0.97)和贫血/围手术期输血（OR 2.18; CI:1.30-3.68）。EMM的风险与低社会经济地位、缺乏私人医疗保险（OR 1.72; CI: 0.99-3.00）、羊膜切开术（OR 1.69; CI:0.97-2.95）和胎膜破裂持续时间较长相关。EMM的风险与年轻和贫血独立相关，并与缺乏私人健康保险和羊膜切开术轻微相关。虽然膜破裂的持续时间与EMM风险的增加只有轻微相关，但在膜破裂后不久就观察到风险的增加。了解这些危险因素对于指导分娩时选择性使用预防性抗生素和提高感染风险最高的亚群的风险意识是重要的。
To determine independent risk factors for endometritis (EMM) following low transverse cesarean section (LTCS). We performed a retrospective case-control study from July 1999 to June 2001 in a large tertiary-care academic hospital. EMM was defined as fever beginning > 24 hours or continuing for ≥ 24 hours after delivery plus fundal tenderness in the absence of other causes for fever. Independent risk factors for EMM were determined by multivariable logistic regression. A fractional polynomial method was used to examine risk of EMM associated with the continuous variable, duration of rupture of membranes. EMM was identified in 124/1605 (7.7%) women within 30 days after LTCS. Independent risk factors for EMM included age (odds ratio (OR) for each additional year 0.93; 95% confidence interval (CI): 0.90-0.97) and anemia/perioperative blood transfusion (OR 2.18; CI:1.30-3.68). Risk of EMM was marginally associated with a proxy for low socioeconomic status, lack of private health insurance (OR 1.72; CI: 0.99-3.00), amniotomy (OR 1.69; CI:0.97-2.95), and longer duration of rupture of membranes. Risk of EMM was independently associated with younger age and anemia, and was marginally associated with lack of private health insurance, and amniotomy. Although duration of rupture of membranes was only marginally associated with increased risk of EMM, increased risk was observed very soon after rupture of membranes. Knowledge of these risk factors is important to guide selective use of prophylactic antibiotics during labor and heighten awareness of the risk in subgroups at highest risk of infection.
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影响因子：
6
作者：
Olsen, MA;Lock-Buckley, P;Fraser, VJ
通讯作者：
Fraser, VJ
DOI：
10.1016/j.jamcollsurg.2008.04.021
发表时间：
2008-09-01
影响因子：
5.2
作者：
Olsen, Margaret A.;Lefta, Mellani;Fraser, Victoria J.
通讯作者：
Fraser, Victoria J.
影响因子：
4.9
作者：
Horan, Teresa C.;Andrus, Mary;Dudeck, Margaret A.
通讯作者：
Dudeck, Margaret A.
影响因子：
8
作者：
Apisarnthanarak, A;Holzmann-Pazgal, G;Fraser, VJ
通讯作者：
Fraser, VJ
影响因子：
7.2
作者：
Burrows, LJ;Meyn, LA;Weber, AM
通讯作者：
Weber, AM