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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Incidence and predictive risk factors of postoperative sepsis in orthopedic trauma patients
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Incidence and predictive risk factors of postoperative sepsis in orthopedic trauma patients

机译：骨伤科患者术后败血症的发生率和预测危险因素

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Postoperative sepsis is associated with high mortality and the national costs of septicemia exceed those of any other diagnosis. While numerous studies in the basic orthopedic science literature suggest that traumatic injuries facilitate the development of sepsis, it is currently unclear whether orthopedic trauma patients are at increased risk. The purpose of this study was thus to assess the incidence of sepsis and determine the risk factors that significantly predicted septicemia following orthopedic trauma surgery. 56,336 orthopedic trauma patients treated between 2006 and 2013 were identified in the ACS-NSQIP database. Documentation of postoperative sepsis/septic shock, demographics, surgical variables, and preoperative comorbidities was collected. Chi-squared analyses were used to assess differences in the rates of sepsis between trauma and nontrauma groups. Binary multivariable regressions identified risk factors that significantly predicted the development of postoperative septicemia in orthopedic trauma patients. There was a significant difference in the overall rates of both sepsis and septic shock between orthopedic trauma (1.6%) and nontrauma (0.5%) patients (p  0.001). For orthopedic trauma patients, ventilator use (OR = 15.1, p = 0.002), history of pain at rest (OR = 2.8, p = 0.036), and prior sepsis (OR = 2.6, p  0.001) were significantly associated with septicemia. Statistically predictive, modifiable comorbidities included hypertension (OR = 2.1, p = 0.003) and the use of corticosteroids (OR = 2.1, p = 0.016). There is a significantly greater incidence of postoperative sepsis in the trauma cohort. Clinicians should be aware of these predictive characteristics, may seek to counsel at-risk patients, and should consider addressing modifiable risk factors such as hypertension and corticosteroid use preoperatively. Level of evidence Level III.
机译：术后败血症与高死亡率相关，全国性败血症的费用超过任何其他诊断的费用。尽管基础骨科学文献中的大量研究表明，外伤会促进败血症的发展，但目前尚不清楚外伤患者的风险是否增加。因此，本研究的目的是评估败血症的发生率，并确定能有效预测骨科创伤手术后败血症的危险因素。在ACS-NSQIP数据库中确定了2006年至2013年之间接受治疗的56,336例骨科创伤患者。收集术后败血症/脓毒性休克，人口统计学，手术变量和术前合并症的文献。卡方分析用于评估创伤组和非创伤组之间败血症发生率的差异。二元多元回归分析确定了可有效预测整形外科创伤患者术后败血症发展的危险因素。骨伤（1.6％）和非创伤（0.5％）患者之间败血症和败血性休克的总体发生率有显着差异（p <0.001）。对于骨伤科患者，使用呼吸机（OR = 15.1，p = 0.002），休息时的疼痛史（OR = 2.8，p = 0.036）和先前的败血症（OR = 2.6，p <0.001）与败血病显着相关。统计上可预测的可改变合并症包括高血压（OR = 2.1，p = 0.003）和使用糖皮质激素（OR = 2.1，p = 0.016）。创伤队列中败血症的发生率明显更高。临床医生应意识到这些预测特征，可以寻求对高危患者的咨询，并应考虑在术前解决诸如高血压和皮质类固醇使用等可改变的危险因素。证据等级III级。

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