Objective To assess the risk factors associated with postoperative infection after elective abdominal operation for elderly in department of general surgery.
Methods One hundred and fifty-nine consecutive elderly patients admitted to the department of general surgery in our hospital for elective abdominal operation between May 2010 and February 2012 were considered for inclusion and retrospectively analyzed. Thirty-eight patients (23.90%)with postoperative infection were taken as the infection group and 121 patients without postoperative infection as noninfection group. The differences in the objective physiological indicators, subjective health status indicators, operation status, the incidence of postoperative infective complications, and mortality were compared between the two groups.
Results Of enrolled 159 patients in this study, the incidence of postoperative infective complications was 23.90% (38/159); 2 patients died, and the postoperative mortality rate was 1.26%. Single factor and multivariate logistic regression analysis showed that preoperative malnutrition risk, history of diabetes, and chronic respiratory system disease were the independent risk factors of postoperative infection complications in elective abdominal surgery for elderly patients.
Conclusion Improving preoperative respiratory function, diabetes mellitus, and nutritional status would help to reduce incidence of postoperative infection for elderly patients with elective abdominal operation.
Citation:
CHEN Hong,LI Fei,JIA Jianguo,SUN Jiabang,.. Analysis on Risk Factors for Infection in Elderly Patients Undergoing Elective Abdominal Operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(10): 1137-1140. doi:
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赵玉萍, 李英. 350 例老年住院患者医院感染因素分析[J]. 中华医院感染学杂志, 2010, 20(2): 207-209.
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赵法荣. ICU老年病人感染103例分析[J]. 中国老年学杂志, 2010, 30(11):1591-1592.
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中华人民共和国卫生部. 医院感染诊断标准(试行)[J]. 中华医学杂志, 2001, 81(5):314-320.
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中华医学会, 中华医院管理学会药事管理专业委员会, 中国药学会医院药学专业委员会. 抗菌药物临床应用指导原则[J]. 中华医学杂志, 2004, 84(22):1857-1862.
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Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials[J]. Clin Nutr, 2003, 22(3):321-336.
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6. |
周立宇, 孙立波, 李永超, 等. 老年胃癌患者术后严重并发症的相关因素分析[J]. 中国普外基础与临床杂志, 2011, 18(6): 639-642.
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Alexander JW, Solomkin JS, Edwards MJ. Updated recommendations for control of surgical site infections[J]. Ann Surg, 2011, 253(6):1082-1093.
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Vogel TR, Dombrovskiy VY, Carson JL, et al. Postoperative sepsis in the United States[J]. Ann Surg, 2010, 252(6):1065-1071.
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Lee JS, Choi HS, Ko YG, et al. Performance of the Geriatric Nutritional Risk Index in predicting 28-day hospital mortality in older adult patients with sepsis[J]. Clin Nutr, 2013, 23(1):1-6.
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10. |
杨平, 陈博, 伍晓汀. 胃癌住院患者营养风险及临床营养支持现状调查[J]. 中国普外基础与临床杂志, 2011, 18(6): 620-624.
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蒋朱明, 陈伟, 朱赛楠, 等. 我国东、中、西部大城市三甲医院营养不良(不足)、营养风险发生率及营养支持应用状况调查[J]. 中国临床营养杂志, 2008, 16(6): 335-337.
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Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novelscreening score for nutritional risk in predicting complications in gastrointestinal surgery[J]. Clin Nutr, 2008, 27(4):565-570.
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Sorensen J, Kondrup J, Prokopowicz J, et al. EuroOOPS:an international, multicentre study to implement nutritional risk scre-ening and evaluate clinical outcome[J]. Clin Nutr, 2008, 27(3):340-349.
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Amaral TF, Matos LC, Tavares MM, et al. The economic impactof disease-related malnutrition at hospital admission[J]. Clin Nutr, 2007, 26(6): 778-784.
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15. |
陈宏, 李非, 贾建国, 等. 择期腹部手术后胰岛素抵抗相关因素研究[J]. 中国实用外科杂志, 2009, 29(5):428-430.
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贾建国, 陈宏, 薛纪秀, 等. 腹部择期手术患者胰岛素抵抗临床观察[J]. 中国临床营养杂志, 2008, 16(3): 152-155.
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江志伟, 李宁, 黎介寿. 快速康复外科的概念及临床意义[J]. 中国实用外科杂志, 2007, 27(2): 131-133.
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姜树旺. 老年患者院内获得性肺感染的临床特征分析[J]. 中国老年学杂志, 2012, 32(9):1841-1842.
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吴宁, 黄方, 齐玉琴, 等. 肠内营养支持在80 岁以上反复肺部感染患者中的应用[J]. 实用老年医学, 2012, 26(5):398-400.
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刘晓琴, 杨雪, 胡翠林. 慢性阻塞性肺病伴肺部感染营养不良的危险因素分析[J]. 实用医院临床杂志, 2012, 9(5):53-55.
|
21. |
金燕芬, 陈芬, 杨皑岚. 老年患者腹腔术后发生下呼吸道医院感染危险因素分析[J]. 中华医院感染学杂志, 2007, 17(11):1359-1361.
|
22. |
张颖辉, 赵霞, 倪锐. 老年患者医院感染因素分析与对策[J]. 中国误诊学杂志, 2009, 9(34):8333-8334.
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- 1. 赵玉萍, 李英. 350 例老年住院患者医院感染因素分析[J]. 中华医院感染学杂志, 2010, 20(2): 207-209.
- 2. 赵法荣. ICU老年病人感染103例分析[J]. 中国老年学杂志, 2010, 30(11):1591-1592.
- 3. 中华人民共和国卫生部. 医院感染诊断标准(试行)[J]. 中华医学杂志, 2001, 81(5):314-320.
- 4. 中华医学会, 中华医院管理学会药事管理专业委员会, 中国药学会医院药学专业委员会. 抗菌药物临床应用指导原则[J]. 中华医学杂志, 2004, 84(22):1857-1862.
- 5. Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials[J]. Clin Nutr, 2003, 22(3):321-336.
- 6. 周立宇, 孙立波, 李永超, 等. 老年胃癌患者术后严重并发症的相关因素分析[J]. 中国普外基础与临床杂志, 2011, 18(6): 639-642.
- 7. Alexander JW, Solomkin JS, Edwards MJ. Updated recommendations for control of surgical site infections[J]. Ann Surg, 2011, 253(6):1082-1093.
- 8. Vogel TR, Dombrovskiy VY, Carson JL, et al. Postoperative sepsis in the United States[J]. Ann Surg, 2010, 252(6):1065-1071.
- 9. Lee JS, Choi HS, Ko YG, et al. Performance of the Geriatric Nutritional Risk Index in predicting 28-day hospital mortality in older adult patients with sepsis[J]. Clin Nutr, 2013, 23(1):1-6.
- 10. 杨平, 陈博, 伍晓汀. 胃癌住院患者营养风险及临床营养支持现状调查[J]. 中国普外基础与临床杂志, 2011, 18(6): 620-624.
- 11. 蒋朱明, 陈伟, 朱赛楠, 等. 我国东、中、西部大城市三甲医院营养不良(不足)、营养风险发生率及营养支持应用状况调查[J]. 中国临床营养杂志, 2008, 16(6): 335-337.
- 12. Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novelscreening score for nutritional risk in predicting complications in gastrointestinal surgery[J]. Clin Nutr, 2008, 27(4):565-570.
- 13. Sorensen J, Kondrup J, Prokopowicz J, et al. EuroOOPS:an international, multicentre study to implement nutritional risk scre-ening and evaluate clinical outcome[J]. Clin Nutr, 2008, 27(3):340-349.
- 14. Amaral TF, Matos LC, Tavares MM, et al. The economic impactof disease-related malnutrition at hospital admission[J]. Clin Nutr, 2007, 26(6): 778-784.
- 15. 陈宏, 李非, 贾建国, 等. 择期腹部手术后胰岛素抵抗相关因素研究[J]. 中国实用外科杂志, 2009, 29(5):428-430.
- 16. 贾建国, 陈宏, 薛纪秀, 等. 腹部择期手术患者胰岛素抵抗临床观察[J]. 中国临床营养杂志, 2008, 16(3): 152-155.
- 17. 江志伟, 李宁, 黎介寿. 快速康复外科的概念及临床意义[J]. 中国实用外科杂志, 2007, 27(2): 131-133.
- 18. 姜树旺. 老年患者院内获得性肺感染的临床特征分析[J]. 中国老年学杂志, 2012, 32(9):1841-1842.
- 19. 吴宁, 黄方, 齐玉琴, 等. 肠内营养支持在80 岁以上反复肺部感染患者中的应用[J]. 实用老年医学, 2012, 26(5):398-400.
- 20. 刘晓琴, 杨雪, 胡翠林. 慢性阻塞性肺病伴肺部感染营养不良的危险因素分析[J]. 实用医院临床杂志, 2012, 9(5):53-55.
- 21. 金燕芬, 陈芬, 杨皑岚. 老年患者腹腔术后发生下呼吸道医院感染危险因素分析[J]. 中华医院感染学杂志, 2007, 17(11):1359-1361.
- 22. 张颖辉, 赵霞, 倪锐. 老年患者医院感染因素分析与对策[J]. 中国误诊学杂志, 2009, 9(34):8333-8334.