Surgical site infection following open lobectomy in patients with lung cancer: A prospective study

IF 3.6 2区医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of Evidence‐Based Medicine Pub Date : 2023-07-03 DOI:10.1111/jebm.12544

Shiyu Li, Ji Lin, Lijuan Ye, Fu Qiao, Wenzhi Huang, Yalan Peng, Jin Huang

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引用次数: 1

Abstract

Objective

To assess the incidence and risk factors of surgical site infection after open pulmonary lobectomy and to quantify their clinical and economic burden.

Methods

A prospective nested case-control study was performed on patients with lung cancer who underwent open lobectomy in the lung cancer center of West China Hospital from January 2017 to December 2019. Demographic, clinical data and medical costs were recorded. Logistic regression was used to evaluate risk factors associated with surgical site infection. A Mann-Whitney U test was carried out to evaluate the differences in medical costs.

Results

A total of 1395 patients were eligible, and the surgical site infection incidence was 13.47% (188/1395). Of the 188 instances of surgical site infection, 171 (90.96%) were classified as organ/space infection, 8 (4.25%) as superficial incisional infection and 9 (4.79%) as deep incisional infection. The patients with surgical site infection had significantly higher mortality (3.19% vs. 0.41%, p < 0.001), higher median medical cost (90774.95 yuan vs. 63079.38 yuan, p < 0.001), and longer postoperative length of stay (15 days vs. 9 days, p < 0.001). Multivariate logistic regression analysis indicated that age (odds ratio (OR) = 1.560, p = 0.007), respiratory failure (OR = 5.984, p = 0.0012), American Society of Anesthesiologists score (OR = 1.584, p = 0.005), operating time (OR = 1.950, p < 0.001), and operation team (OR = 1.864, p < 0.001) were independent risk factors for surgical site infection.

Conclusions

The high incidence of surgical site infection indicates that postoperative infections remain a significant clinical burden in patients who underwent open lobectomy. Identifying risk factors timely through prospective surveillance may assist clinical decisions against surgical site infection.

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肺癌患者开放性肺叶切除术后手术部位感染:一项前瞻性研究

目的评估开放性肺叶切除术后手术部位感染的发生率和危险因素，并量化其临床和经济负担。方法采用前瞻性套式病例对照研究方法，对2017年1月至2019年12月在华西医院癌症中心行肺叶切除术的癌症患者进行研究。记录人口统计学、临床数据和医疗费用。Logistic回归用于评估与手术部位感染相关的危险因素。Mann-Whitney U检验用于评估医疗费用的差异。结果1395例符合条件，手术部位感染发生率为13.47%（188/1395）。在188例手术部位感染中，171例（90.96%）属于器官/间隙感染，8例（4.25%）属于浅切口感染，9例（4.79%）属于深切口感染。手术部位感染患者的死亡率明显更高（3.19%对0.41%，p＜0.001），中位医疗费用更高（90774.95元对63079.38元，p＜0.01），术后住院时间更长（15天对9天，p＜001）。多因素逻辑回归分析表明，年龄（比值比（OR）=1.560，p＝0.007），呼吸衰竭（OR=5.984，p=0.0012）、美国麻醉师学会评分（OR=1.584，p=0.005）、手术时间（OR=1.950，p<；0.001）和手术团队（OR=1.864，p&lgt；0.001）是手术部位感染的独立危险因素。结论手术部位感染的高发率表明，在接受开放性肺叶切除术的患者中，术后感染仍然是一个重要的临床负担。通过前瞻性监测及时识别风险因素可能有助于针对手术部位感染做出临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

11.20

自引率

1.40%

发文量

期刊介绍： The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.