Atopic dermatitis is a novel demographic risk factor for surgical site infection after anterior cruciate ligament reconstruction
Atopic dermatitis is a novel demographic risk factor for surgical site infection after anterior cruciate ligament reconstruction
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DOI：
10.1007/s00167-018-4958-7
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发表时间：
2018-12-01
影响因子：
3.8
通讯作者：
Tanaka, Sakae
中科院分区：
文献类型：
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作者：
Kawata, Manabu;Sasabuchi, Yusuke;Tanaka, Sakae
目的 尽管已经报道了前交叉韧带重建（ACLR）后手术部位感染的各种危险因素，但有关该主题的大样本研究数量有限。本研究的目的是利用日本国家数据库在一个大型队列中阐明 ACLR 后早期手术部位感染的危险因素。 方法 2010 年至 2015 年接受 ACLR 的患者数据来自诊断程序组合数据库，该数据库涵盖了日本住院总人数的约一半。结果指标是住院期间 ACLR 后手术部位感染和深部手术部位感染的发生率。使用多变量逻辑回归模型检查手术部位感染的发生与患者的人口统计数据（包括性别、年龄、体重指数（BMI）、吸烟状况、术前类固醇使用以及糖尿病、肝功能障碍、肾功能障碍和特应性皮炎等合并症）之间的关联。 结果 在 30,536 名接受手术的患者中 ACLR 发现 288 例手术部位感染患者（0.94%）和 86 例深部手术部位感染患者（0.28%）。单变量分析显示，手术部位感染和深部手术部位感染的发生率较高与男性、较高的BMI、特应性皮炎和术前使用类固醇有关。患有糖尿病或肝功能障碍的患者手术部位感染的发生率显着较高。多变量分析表明，手术部位感染与男性与女性显着相关；比值比（OR），2.90； 95% 置信区间 (CI)，2.17-3.89，年龄 = 30.0 vs. 18.5-22.9 kg/m(2)；或，1.72； 95% CI 1.16-2.54、糖尿病（OR，2.70；95% CI 1.28-5.71）、特应性皮炎（OR，7.19；95% CI 2.94-17.57）和术前类固醇使用（OR，6.18；95% CI 2.32-16.52）。结论 特应性皮炎、术前类固醇使用、年轻 (= 30.0 kg/m(2))、男性和糖尿病是 ACLR 后手术部位感染的独立人口统计学危险因素。当外科医生从人口统计学方面评估 ACLR 后 SSI 的风险时，本研究将很有用。
Purpose Although various risk factors for surgical site infection after anterior cruciate ligament reconstruction (ACLR) have been reported, the number of studies with large sample sizes on this topic is limited. The aim of the present study was to clarify the risk factors for early surgical site infection after ACLR in a large cohort using a national database in Japan.Methods The data of patients who underwent ACLR from 2010 to 2015 were obtained from the Diagnosis Procedure Combination database, which covers approximately half of all hospital admissions in Japan. The outcome measures were the prevalences of surgical site infection and deep surgical site infection after ACLR during hospitalization. The association between the occurrence of surgical site infection and patients' demographic data, including sex, age, body mass index (BMI), smoking status, preoperative steroid use, and comorbidities such as diabetes, hepatic dysfunction, renal dysfunction, and atopic dermatitis, were examined using a multivariable logistic regression model.Results Among 30,536 patients who underwent ACLR, 288 patients with surgical site infection (0.94%) and 86 with deep surgical site infection (0.28%) were identified. The univariate analysis showed that higher prevalences of surgical site infection and deep surgical site infection were associated with male sex, a higher BMI, atopic dermatitis, and preoperative steroid use. Patients with diabetes or hepatic dysfunction had a significantly higher prevalence of surgical site infection. The multivariable analysis showed that surgical site infection was significantly associated with male sex vs. female sex; odds ratio (OR), 2.90; 95% confidence interval (CI), 2.17-3.89, age of = 30.0 vs. 18.5-22.9 kg/m(2); OR, 1.72; 95% CI 1.16-2.54, diabetes (OR, 2.70; 95% CI 1.28-5.71), atopic dermatitis (OR, 7.19; 95% CI 2.94-17.57), and preoperative steroid use (OR, 6.18; 95% CI 2.32-16.52).Conclusion Atopic dermatitis, preoperative steroid use, young age (= 30.0 kg/m(2)), male sex, and diabetes were independent demographic risk factors for surgical site infection after ACLR. The present study will be useful when surgeons evaluate the risk of SSI after ACLR in terms of demographic aspects.