韩国的一项多中心有关胃手术危险因素研究

楚楚

Infect Control Hosp Epidemiol. 2012 Jun;33(6):572-80. Epub 2012 Apr 19.
Prospective nationwide surveillance of surgical site infections after gastric surgery and risk factor analysis in the Korean Nosocomial Infections Surveillance System (KONIS).Kim ES, Kim HB, Song KH, Kim YK, Kim HH, Jin HY, Jeong SY, Sung J, Cho YK, Lee YS, Oh HB, Kim EC, Kim JM, Choi TY, Choi HJ, Kim HY; Korean Nosocomial Infections Surveillance System (KONIS).
SourceDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

AbstractOBJECTIVE: To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.
DESIGN: A nationwide prospective multicenter study.
SETTING: Twenty university-affiliated hospitals in Korea.
METHODS: The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.
RESULTS: Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (± SD) was 58.8 (± 12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09-2.58]), increased operation time (1.20 [1.07-1.34] per 1-hour increase), reoperation (7.27 [3.68-14.38]), combined multiple procedures (1.79 [1.13-2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09-8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26-5.64]) were independently associated with increased risk of SSI.
主要结论是胃手术的危险因素有男性、手术时间长（每增加1个小时风险增至1.2倍）、再手术、多种手术、切皮后使用抗菌药物、抗菌药物使用时间长于7天。
CONCLUSIONS: Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.

樵夫

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