Risk factors for surgical sites infection in patients undergoing craniotomy

doi:10.3877/cma.j.issn.1674-1358.2017.01.007

Abstract

Abstract:

Objective

To investigate the risk factors for surgical site infection (SSI) in patients with craniotomy, and to provide reference for prevention and control strategies of SSI.

Methods

Total of 545 patients after craniocerebral operation were observed by prospective targeted surveillance method. The clinical data were analyzed by statistical software SPSS 19.0.

Results

Among the 545 cases, 32 had postoperative SSI, the infection rate was 5.87%. The univariate analysis showed that longer than 4 hours of operation time, intraoperative blood loss more than 300 ml, without prophylactic use of antibiotics, prolonged postoperative and overall hospitalization were high risk factors for SSI (all P < 0.05). The multivariate logistic regression analysis suggested that prophylactic use of antibiotics was an independently protective factor for SSI (OR = 0.256, 95%CI: 0.090-0.726), while the prolonged overall hospitalization was an independently risk factor for the occurrence of SSI (OR = 6.601, 95%CI: 1.136-38.350).

Conclusions

The incidence of SSI among patients undergoing craniotomy was the combined effect of several factors. Comprehensive interventions should be actively adopted, in order to reduce the rate of surgical sites infection.

Key words: Craniotomy, Surgical site infection, Risk factor

Ling Zhang, Xia Chen, Guiming Wang. Risk factors for surgical sites infection in patients undergoing craniotomy[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(01): 32-35.

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References 21

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相关因素		监测例数（n = 545）	感染例数（n = 32）	感染率（%）	χ²值	P值
性别（例）					0.188	0.665
	男	338	21	6.21
	女	207	11	5.31
年龄（岁）					0.550	0.458
	≤ 54	256	13	5.08
	> 54	289	19	6.57
手术类型					0.513	0.474
	急诊	141	10	7.09
	择期	404	22	5.45
麻醉类型					2.177	0.140
	全身麻醉	324	23	7.10
	非全身麻醉	221	9	4.07
手术时间（h）					4.369	0.037^a
	< 4	394	18	4.57
	≥ 4	151	14	9.27
术中失血量（ml）					7.400	0.007^a
	< 300	359	14	3.90
	≥ 300	186	18	9.68
ASA评分（分）					2.229	0.135
	1、2	257	11	4.28
	3、4、5	288	21	7.29
切口等级					0.274	0.872
	Ⅰ	523	31	5.93
	Ⅱ	20	1	5.00
	Ⅲ	2	0	0.00
腔镜					0.442	1.000
	无	538	32	5.95
	有	7	0	0.00
植入物					0.693	0.405
	无	447	28	6.26
	有	98	4	4.08
预防性应用抗菌药物					7.686	0.006^a
	否	37	6	16.22
	是	508	26	5.12
术前住院天数（d）
	< 5	398	20	5.03	1.913	0.167
	≥ 5	147	12	8.16
术后住院天数（d）					18.760	< 0.001^a
	< 14	253	3	1.19
	≥ 14	292	29	9.93
全部住院天数（d）					24.229	< 0.001^a
	< 18	264	2	0.76
	≥ 18	281	30	10.68

相关因素		监测例数（n = 545）	感染例数（n = 32）	感染率（%）	χ²值	P值
性别（例）					0.188	0.665
	男	338	21	6.21
	女	207	11	5.31
年龄（岁）					0.550	0.458
	≤ 54	256	13	5.08
	> 54	289	19	6.57
手术类型					0.513	0.474
	急诊	141	10	7.09
	择期	404	22	5.45
麻醉类型					2.177	0.140
	全身麻醉	324	23	7.10
	非全身麻醉	221	9	4.07
手术时间（h）					4.369	0.037^a
	< 4	394	18	4.57
	≥ 4	151	14	9.27
术中失血量（ml）					7.400	0.007^a
	< 300	359	14	3.90
	≥ 300	186	18	9.68
ASA评分（分）					2.229	0.135
	1、2	257	11	4.28
	3、4、5	288	21	7.29
切口等级					0.274	0.872
	Ⅰ	523	31	5.93
	Ⅱ	20	1	5.00
	Ⅲ	2	0	0.00
腔镜					0.442	1.000
	无	538	32	5.95
	有	7	0	0.00
植入物					0.693	0.405
	无	447	28	6.26
	有	98	4	4.08
预防性应用抗菌药物					7.686	0.006^a
	否	37	6	16.22
	是	508	26	5.12
术前住院天数（d）
	< 5	398	20	5.03	1.913	0.167
	≥ 5	147	12	8.16
术后住院天数（d）					18.760	< 0.001^a
	< 14	253	3	1.19
	≥ 14	292	29	9.93
全部住院天数（d）					24.229	< 0.001^a
	< 18	264	2	0.76
	≥ 18	281	30	10.68

变量	β值	S.E.值	P值	OR值	95%CI
手术时间	0.569	0.454	0.210	1.767	0.726～4.300
术中失血量	0.544	0.447	0.223	1.722	0.718～4.134
预防性应用抗菌药物	-1.364	0.532	0.010^a	0.256	0.090～0.726
术后住院天数	0.970	0.766	0.205	2.639	0.589～11.835
全部住院天数	1.887	0.898	0.036^a	6.601	1.136～38.350

变量	β值	S.E.值	P值	OR值	95%CI
手术时间	0.569	0.454	0.210	1.767	0.726～4.300
术中失血量	0.544	0.447	0.223	1.722	0.718～4.134
预防性应用抗菌药物	-1.364	0.532	0.010^a	0.256	0.090～0.726
术后住院天数	0.970	0.766	0.205	2.639	0.589～11.835
全部住院天数	1.887	0.898	0.036^a	6.601	1.136～38.350

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