Risk factors for surgical site infection after elective resection of the colon and rectum: A single-center prospective study of 2,809 consecutive patients
Risk factors for surgical site infection after elective resection of the colon and rectum: A single-center prospective study of 2,809 consecutive patients
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DOI：
10.1097/00000658-200108000-00007
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发表时间：
2001-08-01
影响因子：
9
通讯作者：
Wang, JY
中科院分区：
文献类型：
--
作者：
Tang, RP;Chen, HH;Wang, JY
目的确定择期结肠直肠切除术患者手术部位感染（SSI）的危险因素。背景数据摘要SSI 导致大量死亡和并发症。确定 SSI 的危险因素可以提供减少并发症和改善预后的信息。方法作者对 1995 年 2 月至 1998 年 12 月期间在同一机构连续 2,809 名通过剖腹手术接受择期结直肠切除术的患者进行了前瞻性研究。感兴趣的结果是SSI，它被分类为有或没有临床漏的切口或器官/空间，使用似然比正向回归模型来评估变量与SSI的独立关联。结果有和没有临床吻合口漏的总体SSI、切口SSI和器官/空间SSI的发生率分别为4.7%、3%、2%和0.8%。总体 SSI 的危险因素为美国麻醉学会 (ASA) 评分 2 或 3（比值比 [OR] = 1.7）、男性（OR = 1.5）、外科医生（OR = 1.3-3.3）、手术类型（OR = 0.3-2.1）、造口术（OR = 2.1）、伤口污染（OR = 2.9）、引流的使用（OR = 1.6）、术中或术后输血（1-3 单位，OR = 5.3；大于或等于 4 单位，OR = 6.2）。然而，特定地点的 SSI 的风险因素各不相同。在各种危险因素中，只有输血与任何特定部位的 SSI 风险始终相关。 结论 除了 ASA 评分和手术伤口类别外，输血、造口术、手术类型、引流使用、性别和外科医生对于预测择期结直肠切除术后 SSI 也很重要。
ObjectiveTo identify the risk factors for surgical site infection (SSI) in patients undergoing elective resection of the colon and rectum.Summary Background DataSSI causes a substantial number of deaths and complications. Determining risk factors for SSI may provide information on reducing complications and improving outcome.MethodsThe authors performed a prospective study of 2,809 consecutive patients undergoing elective colorectal resection via laparotomy between February 1995 and December 1998 at a single institution. The outcome of interest was SSI, which was classified as being incisional or organ/space with or without clinical leakage, A likelihood ratio forward regression model was used to assess the independent association of variables with SSIs.ResultsThe overall SSI, incisional SSI, and organ/space SSI with and without clinical anastomotic leakage rates were 4.7%, 3%, 2%, and 0.8%, respectively. Risk factors for overall SSI were American Society of Anesthesiology (ASA) score 2 or 3 (odd ratio [OR] = 1.7), male gender (OR = 1.5), surgeons (OR = 1.3-3.3), types of operation (OR = 0.3-2.1), creation of ostomy (OR = 2.1), contaminated wound (OR = 2.9), use of drainage (OR = 1.6), and intra- or postoperative blood transfusion (1-3 units, OR = 5.3; greater than or equal to4 units, OR = 6.2). However, SSIs at specific sites differed from each other with respect to the risk factors. Among a variety of risk factors, only blood transfusion was consistently associated with a risk of SSI at any specific site.ConclusionsIn addition to ASA score and surgical wound class, blood transfusion, creation of ostomy, types of operation, use of drainage, sex, and surgeons were important in predicting SSIs after elective colorectal resection.