Introduction: Health-care-associated infection (HAI) is a major global safety issue for patients, health care managers and health-care professionals. One of HAI is surgical site infection (SSI). SSI is refers to an infection that occurs after surgery in the part of the body where surgery took place. It arises following surgery and is specifically related to the surgical site. It is estimated that SSIs account between 10-30% of all HAIs. Objective: The objectives of this study was to quantify the rate of wound infection and identify determinant factors Method: Prospective observational study was conducted from January to June 05/2019. All adult patients who met inclusion criteria were included in the study. The data was obtained either directly from the patient, or by observations or from the patient’s file. All patients were followed daily before, during and after operation for 30 days starting from the date of operation. Wound infection was detected at bedside and post-discharge surveillance. Chi-square test was computed to evaluate adequacy of cells for regression analysis. Independent predictors identified using binary logistic regression analysis and statistical significance was considered at p<0.05. Results: Two hundred eighty patients were included with mean age of 42.5±11 and 157(56.1%) patients were females. Caesarean section is the most common type of surgery. The rate of wound infection was found to be 80 (28.57%). The highest SSI rate was observed in gastrointestinal surgery 28(35.0). More than half of the cases were developed in health institution and patients having clean contaminated wound share the highest number. Majority of patients were undergoing emergency surgery with mean duration of surgery 1.8±0.65 hours. Multivariate analysis revealed that seven variables were significantly associated with the prevalence of wound infection; namely patient’s body mass index (P=0.037), age (P=0.046), history of previous surgery (P=0.04), preoperative hospital stay (p=0.0091), wound class (p=0.01) and history of steroid use (p= 0.027). Conclusion: In this study the rate of wound infection was high with patient’s physical status, duration of surgery, previous steroid use being strong predictor of infection. Life style modification is important to reduce body mass index and health professionals should counsel them.
{"title":"Surgical site infection and predictors among adults in specialized hospital: prospective observational study","authors":"B. Kebede, Biset Asredaw","doi":"10.21203/rs.2.15775/v1","DOIUrl":"https://doi.org/10.21203/rs.2.15775/v1","url":null,"abstract":"\u0000 Introduction: Health-care-associated infection (HAI) is a major global safety issue for patients, health care managers and health-care professionals. One of HAI is surgical site infection (SSI). SSI is refers to an infection that occurs after surgery in the part of the body where surgery took place. It arises following surgery and is specifically related to the surgical site. It is estimated that SSIs account between 10-30% of all HAIs. Objective: The objectives of this study was to quantify the rate of wound infection and identify determinant factors Method: Prospective observational study was conducted from January to June 05/2019. All adult patients who met inclusion criteria were included in the study. The data was obtained either directly from the patient, or by observations or from the patient’s file. All patients were followed daily before, during and after operation for 30 days starting from the date of operation. Wound infection was detected at bedside and post-discharge surveillance. Chi-square test was computed to evaluate adequacy of cells for regression analysis. Independent predictors identified using binary logistic regression analysis and statistical significance was considered at p<0.05. Results: Two hundred eighty patients were included with mean age of 42.5±11 and 157(56.1%) patients were females. Caesarean section is the most common type of surgery. The rate of wound infection was found to be 80 (28.57%). The highest SSI rate was observed in gastrointestinal surgery 28(35.0). More than half of the cases were developed in health institution and patients having clean contaminated wound share the highest number. Majority of patients were undergoing emergency surgery with mean duration of surgery 1.8±0.65 hours. Multivariate analysis revealed that seven variables were significantly associated with the prevalence of wound infection; namely patient’s body mass index (P=0.037), age (P=0.046), history of previous surgery (P=0.04), preoperative hospital stay (p=0.0091), wound class (p=0.01) and history of steroid use (p= 0.027). Conclusion: In this study the rate of wound infection was high with patient’s physical status, duration of surgery, previous steroid use being strong predictor of infection. Life style modification is important to reduce body mass index and health professionals should counsel them.","PeriodicalId":53460,"journal":{"name":"European Journal of Clinical Pharmacy","volume":"22 1","pages":"10-19"},"PeriodicalIF":0.0,"publicationDate":"2019-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46557351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-03-18DOI: 10.5176/2251-2489_BIOTECH13.34
O. Nayel, M. Sobhy, A. Baraka, Mohammed El Samak, C. Kader
The potential implication of P1A gene variants of GPIIIa of platelet GP IIb/IIIa as a genetic risk factor provocateur and/or a therapeutic outcome modulator to anti-platelet therapy in acute coronary syndrome (ACS) was probed. Study enrolled 22 controls and 44 ACS patients [non-ST segment elevation myocardial infarction (NSTEMI) vs ST segment elevation myocardial infarction (STEMI)]. They were risk stratified (TIMI score), sampled for genotyping and estimation of platelet aggregation, then subdivided according to add-on anti-platelet therapy into: clopidogrel or tirofiban subgroups. After 48 hours, the therapeutic outcome was assessed; clinically, pain relief or complication prevalence (symptomatic, electrocardiographic or hemorrhagic) and the investigational estimates were re-assessed. Intra-procedural evaluation of chest pain, ECG tracing and angiographic findings (number of culprit vessels, thrombus extent, TIMI flow, and myocardial blush) was reported in patients who underwent PCI. Frequency of plA2vs plA1 allele was higher in ACS patients (significant in ≤60 years/doubled in STEMI vs NSTEMI). TIMI score, stratification permitted considering P1A2 variant as independent risk factor in UA/NSTEMI subsets. This was fostered by intra-procedural finding of more stenotic and thrombotic lesions in P1A2 carriers. A lack of significant association between P1A variants and changes in platelet aggregation, debate its causal relation to P1A2 variant being an ACS risk factor. A positive correlation was observed between P1A variants and the therapeutic response outcome to both clopidogrel and tirofiban regarding platelet aggregation and relief of chest pain. Thus, P1A2 variant could be considered a genetic risk factor contributor rather than an anti-platelet therapeutic response modulator, when speaking of ACS. This awaits larger scale pharmacogenomic studies before a final statement is declared so as to individualize anti-platelet therapy to the best of its therapeutic outcome in ACS settings
探讨血小板GPIIIa P1A基因变异对急性冠状动脉综合征(ACS)患者抗血小板治疗的潜在影响，作为遗传危险因素引发和/或治疗结果调节剂。研究纳入22名对照组和44名ACS患者[非ST段抬高型心肌梗死(NSTEMI) vs ST段抬高型心肌梗死(STEMI)]。对他们进行风险分层(TIMI评分)，取样进行基因分型和血小板聚集估计，然后根据附加抗血小板治疗细分为:氯吡格雷或替罗非班亚组。48小时后，评估治疗结果;临床，疼痛缓解或并发症患病率(症状、心电图或出血)和研究估计被重新评估。报道了行PCI的患者术中胸痛评估、心电图示图和血管造影结果(罪魁血管数量、血栓范围、TIMI血流和心肌红晕)。ACS患者plA2vs plA1等位基因的频率更高(≤60岁显著/ STEMI vs NSTEMI两倍)。TIMI评分，分层允许考虑P1A2变异作为UA/NSTEMI亚群的独立危险因素。这是由于P1A2携带者在手术中发现了更多的狭窄和血栓性病变。P1A变异体与血小板聚集变化之间缺乏显著的关联，争论其与P1A2变异体是否是ACS危险因素的因果关系。在血小板聚集和胸痛缓解方面，P1A变异与氯吡格雷和替罗非班的治疗反应结果呈正相关。因此，当谈到ACS时，P1A2变异可以被认为是一个遗传风险因素，而不是抗血小板治疗反应调节剂。这需要更大规模的药物基因组学研究，然后才能宣布最终结论，以便在ACS环境下个体化抗血小板治疗以达到最佳治疗效果
{"title":"The relevance of platelet glycoprotein GP IIb/IIIa polymorphism to anti-platelets response in acute coronary syndrome","authors":"O. Nayel, M. Sobhy, A. Baraka, Mohammed El Samak, C. Kader","doi":"10.5176/2251-2489_BIOTECH13.34","DOIUrl":"https://doi.org/10.5176/2251-2489_BIOTECH13.34","url":null,"abstract":"The potential implication of P1A gene variants of GPIIIa of platelet GP IIb/IIIa as a genetic risk factor provocateur and/or a therapeutic outcome modulator to anti-platelet therapy in acute coronary syndrome (ACS) was probed. Study enrolled 22 controls and 44 ACS patients [non-ST segment elevation myocardial infarction (NSTEMI) vs ST segment elevation myocardial infarction (STEMI)]. They were risk stratified (TIMI score), sampled for genotyping and estimation of platelet aggregation, then subdivided according to add-on anti-platelet therapy into: clopidogrel or tirofiban subgroups. After 48 hours, the therapeutic outcome was assessed; clinically, pain relief or complication prevalence (symptomatic, electrocardiographic or hemorrhagic) and the investigational estimates were re-assessed. Intra-procedural evaluation of chest pain, ECG tracing and angiographic findings (number of culprit vessels, thrombus extent, TIMI flow, and myocardial blush) was reported in patients who underwent PCI. Frequency of plA2vs plA1 allele was higher in ACS patients (significant in ≤60 years/doubled in STEMI vs NSTEMI). TIMI score, stratification permitted considering P1A2 variant as independent risk factor in UA/NSTEMI subsets. This was fostered by intra-procedural finding of more stenotic and thrombotic lesions in P1A2 carriers. A lack of significant association between P1A variants and changes in platelet aggregation, debate its causal relation to P1A2 variant being an ACS risk factor. A positive correlation was observed between P1A variants and the therapeutic response outcome to both clopidogrel and tirofiban regarding platelet aggregation and relief of chest pain. Thus, P1A2 variant could be considered a genetic risk factor contributor rather than an anti-platelet therapeutic response modulator, when speaking of ACS. This awaits larger scale pharmacogenomic studies before a final statement is declared so as to individualize anti-platelet therapy to the best of its therapeutic outcome in ACS settings","PeriodicalId":53460,"journal":{"name":"European Journal of Clinical Pharmacy","volume":"19 1","pages":"83-92"},"PeriodicalIF":0.0,"publicationDate":"2013-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70797891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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