NNIS风险指数在手术部位感染应用的效果评估

发布时间：2018-04-21 23:03

本文选题：手术部位感染 + NNIS风险指数　；参考：《中华医院感染学杂志》2017年08期

【摘要】：目的评估NNIS风险指数在手术部位感染的应用效果,为NNIS风险调整作参考。方法回顾性收集2014年1月-2016年8月12所医院14 308例手术病例资料,计算不同手术不同NNIS风险组的感染率,应用Spearman秩相关检验分析NNIS风险等级与感染率的相关关系,以受试者工作特征曲线(ROC)下面积(AUC)评价NNIS风险指数对不同手术术后感染的预测能力。结果 NNIS-0、1级、2级、3级感染率分别为1.77%、5.85%、13.13%、26.14%,Spearman秩相关系数为0.642,P0.01;结直肠切除、开腹胆囊及胆管手术的AUC分别为0.731、0.721、0.717,长骨骨折切开复位内固定、髋关节置换、冠状动脉搭桥、腹式子宫切除的AUC分别为0.634、0.608、0.646、0.623,剖宫产AUC为0.502。结论 NNIS风险指数作为手术部位感染风险分层工具判别能力较好,对感染率高的手术预测能力优于感染率低的手术,如能根据我国的情况对NNIS风险指数进行风险调整或许能够让其作用发挥更有效。
[Abstract]:Objective to evaluate the effect of NNIS risk index in patients with surgical site infection and to provide a reference for the adjustment of NNIS risk. Methods the data of 14 308 surgical patients in 12 hospitals from January 2014 to August 2016 were collected retrospectively. The infection rate of different NNIS risk groups was calculated. The Spearman rank correlation test was used to analyze the correlation between NNIS risk grade and infection rate. The area under the operating characteristic curve (ROC) was used to evaluate the predictive ability of NNIS risk index for different postoperative infections. Results the infection rate of NNIS-0 grade 1 and grade 2 and grade 3 were 1.77 and 5.85, respectively, and the rank correlation coefficient of Spearman was 0.642p0.01.The AUC of colorectal resection, cholecystectomy, cholecystectomy and bile duct surgery were 0.721 ~ 0.717, respectively, open reduction and internal fixation of long bone fracture, hip replacement, coronary artery bypass graft, and so on. The AUC of abdominal hysterectomy and cesarean section were 0.634 and 0.608, respectively. The AUC of caesarean section was 0.502. Conclusion NNIS risk index is a good tool for distinguishing infection risk in surgical site, and it is superior to surgery with low infection rate in predicting the infection rate. If we can adjust the risk of NNIS risk index according to the situation of our country, we can make it more effective.
【作者单位】：石河子大学医学院第一附属医院院内感染控制办公室;滨州医学院附属医院院内感染控制办公室;甘肃省武威肿瘤医院医院感染管理科;山东大学齐鲁医院医院感染管理处;广东省人民医院检验科;
【基金】：新疆生产建设兵团卫生科技基金资助项目(XJBTWK-201602)
【分类号】：R619.3

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