1.Surgical site infection after abdominal surgery in China: a multicenter cross-sectional study
Xufei ZHANG ; Jun CHEN ; Peige WANG ; Suming LUO ; Naxin LIU ; Xuemin LI ; Xianli HE ; Yi WANG ; Xiaogang BI ; Ping ZHANG ; Yong WANG ; Zhongchuan LV ; Bo ZHOU ; Wei MAI ; Hua WU ; Yang HU ; Daorong WANG ; Fuwen LUO ; Ligang XIA ; Jiajun LAI ; Dongming ZHANG ; Qian WANG ; Gang HAN ; Xiuwen WU ; Jian'an REN
Chinese Journal of Gastrointestinal Surgery 2020;23(11):1036-1042
Objective:Surgical site infection (SSI) can markedly prolong postoperative hospital stay, aggravate the burden on patients and society, even endanger the life of patients. This study aims to investigate the national incidence of SSI following abdominal surgery and to analyze the related risk factors in order to provide reference for the control and prevention of SSI following abdominal surgery.Methods:A multicenter cross-sectional study was conducted. Clinical data of all the adult patients undergoing abdominal surgery in 68 hospitals across the country from June 1 to 30, 2020 were collected, including demographic characteristics, clinical parameters during the perioperative period, and the results of microbial culture of infected incisions. The primary outcome was the incidence of SSI within postoperative 30 days, and the secondary outcomes were ICU stay, postoperative hospital stay, cost of hospitalization and the mortality within postoperative 30-day. Multivariable logistic regression was used to analyze risk factors of SSI after abdominal surgery.Results:A total of 5560 patients undergoing abdominal surgery were included, and 163 cases (2.9%) developed SSI after surgery, including 98 cases (60.1%) with organ/space infections, 19 cases (11.7%) with deep incisional infections, and 46 cases (28.2%) with superficial incisional infections. The results from microbial culture showed that Escherichia coli was the main pathogen of SSI. Multivariate analysis revealed hypertension (OR=1.792, 95% CI: 1.194-2.687, P=0.005), small intestine as surgical site (OR=6.911, 95% CI: 1.846-25.878, P=0.004), surgical duration (OR=1.002, 95% CI: 1.001-1.003, P<0.001), and surgical incision grade (contaminated incision: OR=3.212, 95% CI: 1.495-6.903, P=0.003; Infection incision: OR=11.562, 95%CI: 3.777-35.391, P<0.001) were risk factors for SSI, while laparoscopic or robotic surgery (OR=0.564, 95%CI: 0.376-0.846, P=0.006) and increased preoperative albumin level (OR=0.920, 95%CI: 0.888-0.952, P<0.001) were protective factors for SSI. In addition, as compared to non-SSI patients, the SSI patients had significantly higher rate of ICU stay [26.4% (43/163) vs. 9.5% (514/5397), χ 2=54.999, P<0.001] and mortality within postoperative 30-day [1.84% (3/163) vs.0.01% (5/5397), χ 2=33.642, P<0.001], longer ICU stay (median: 0 vs. 0, U=518 414, P<0.001), postoperative hospital stay (median: 17 days vs. 7 days, U=656 386, P<0.001), and total duration of hospitalization (median: 25 days vs. 12 days, U=648 129, P<0.001), and higher hospitalization costs (median: 71 000 yuan vs. 39 000 yuan, U=557 966, P<0.001). Conclusions:The incidence of SSI after abdominal surgery is 2.9%. In order to reduce the incidence of postoperative SSI, hypoproteinemia should be corrected before surgery, laparoscopic or robotic surgery should be selected when feasible, and the operating time should be minimized. More attentions should be paid and nursing should be strengthened for those patients with hypertension, small bowel surgery and seriously contaminated incision during the perioperative period.
2.Risk factors for surgical site infection after emergency abdominal surgery: a multicenter cross-sectional study in China
Ze LI ; Junru GAO ; Li SONG ; Peige WANG ; Jian'an REN ; Xiuwen WU ; Suming LUO ; Qingjun ZENG ; Yanhong WENG ; Xinjian XU ; Qingzhong YUAN ; Jie ZHAO ; Nansheng LIAO ; Wei MAI ; Feng WANG ; Hui CAO ; Shichen WANG ; Gang HAN ; Daorong WANG ; Hao WANG ; Jun ZHANG ; Hao ZHANG ; Dongming ZHANG ; Weishun LIAO ; Wanwen ZHAO ; Wei LI ; Peng CUI ; Xin CHEN ; Haiyang ZHANG ; Tao YANG ; Lie WANG ; Yongshun GAO ; Jiang LI ; Jianjun WU ; Wei ZHOU ; Zejian LYU ; Jian FANG
Chinese Journal of Gastrointestinal Surgery 2020;23(11):1043-1050
Objective:Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence.Methods:Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS.Results:A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ 2=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ 2=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ 2=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ 2=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ 2=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ 2=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ 2=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions:For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.
3.Surgical site infection after abdominal surgery in China: a multicenter cross-sectional study
Xufei ZHANG ; Jun CHEN ; Peige WANG ; Suming LUO ; Naxin LIU ; Xuemin LI ; Xianli HE ; Yi WANG ; Xiaogang BI ; Ping ZHANG ; Yong WANG ; Zhongchuan LV ; Bo ZHOU ; Wei MAI ; Hua WU ; Yang HU ; Daorong WANG ; Fuwen LUO ; Ligang XIA ; Jiajun LAI ; Dongming ZHANG ; Qian WANG ; Gang HAN ; Xiuwen WU ; Jian'an REN
Chinese Journal of Gastrointestinal Surgery 2020;23(11):1036-1042
Objective:Surgical site infection (SSI) can markedly prolong postoperative hospital stay, aggravate the burden on patients and society, even endanger the life of patients. This study aims to investigate the national incidence of SSI following abdominal surgery and to analyze the related risk factors in order to provide reference for the control and prevention of SSI following abdominal surgery.Methods:A multicenter cross-sectional study was conducted. Clinical data of all the adult patients undergoing abdominal surgery in 68 hospitals across the country from June 1 to 30, 2020 were collected, including demographic characteristics, clinical parameters during the perioperative period, and the results of microbial culture of infected incisions. The primary outcome was the incidence of SSI within postoperative 30 days, and the secondary outcomes were ICU stay, postoperative hospital stay, cost of hospitalization and the mortality within postoperative 30-day. Multivariable logistic regression was used to analyze risk factors of SSI after abdominal surgery.Results:A total of 5560 patients undergoing abdominal surgery were included, and 163 cases (2.9%) developed SSI after surgery, including 98 cases (60.1%) with organ/space infections, 19 cases (11.7%) with deep incisional infections, and 46 cases (28.2%) with superficial incisional infections. The results from microbial culture showed that Escherichia coli was the main pathogen of SSI. Multivariate analysis revealed hypertension (OR=1.792, 95% CI: 1.194-2.687, P=0.005), small intestine as surgical site (OR=6.911, 95% CI: 1.846-25.878, P=0.004), surgical duration (OR=1.002, 95% CI: 1.001-1.003, P<0.001), and surgical incision grade (contaminated incision: OR=3.212, 95% CI: 1.495-6.903, P=0.003; Infection incision: OR=11.562, 95%CI: 3.777-35.391, P<0.001) were risk factors for SSI, while laparoscopic or robotic surgery (OR=0.564, 95%CI: 0.376-0.846, P=0.006) and increased preoperative albumin level (OR=0.920, 95%CI: 0.888-0.952, P<0.001) were protective factors for SSI. In addition, as compared to non-SSI patients, the SSI patients had significantly higher rate of ICU stay [26.4% (43/163) vs. 9.5% (514/5397), χ 2=54.999, P<0.001] and mortality within postoperative 30-day [1.84% (3/163) vs.0.01% (5/5397), χ 2=33.642, P<0.001], longer ICU stay (median: 0 vs. 0, U=518 414, P<0.001), postoperative hospital stay (median: 17 days vs. 7 days, U=656 386, P<0.001), and total duration of hospitalization (median: 25 days vs. 12 days, U=648 129, P<0.001), and higher hospitalization costs (median: 71 000 yuan vs. 39 000 yuan, U=557 966, P<0.001). Conclusions:The incidence of SSI after abdominal surgery is 2.9%. In order to reduce the incidence of postoperative SSI, hypoproteinemia should be corrected before surgery, laparoscopic or robotic surgery should be selected when feasible, and the operating time should be minimized. More attentions should be paid and nursing should be strengthened for those patients with hypertension, small bowel surgery and seriously contaminated incision during the perioperative period.
4.Risk factors for surgical site infection after emergency abdominal surgery: a multicenter cross-sectional study in China
Ze LI ; Junru GAO ; Li SONG ; Peige WANG ; Jian'an REN ; Xiuwen WU ; Suming LUO ; Qingjun ZENG ; Yanhong WENG ; Xinjian XU ; Qingzhong YUAN ; Jie ZHAO ; Nansheng LIAO ; Wei MAI ; Feng WANG ; Hui CAO ; Shichen WANG ; Gang HAN ; Daorong WANG ; Hao WANG ; Jun ZHANG ; Hao ZHANG ; Dongming ZHANG ; Weishun LIAO ; Wanwen ZHAO ; Wei LI ; Peng CUI ; Xin CHEN ; Haiyang ZHANG ; Tao YANG ; Lie WANG ; Yongshun GAO ; Jiang LI ; Jianjun WU ; Wei ZHOU ; Zejian LYU ; Jian FANG
Chinese Journal of Gastrointestinal Surgery 2020;23(11):1043-1050
Objective:Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence.Methods:Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS.Results:A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ 2=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ 2=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ 2=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ 2=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ 2=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ 2=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ 2=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions:For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.
5.Diagnostic value of combined detection of VEGF, SAA and hs-CRP for acute cerebral infarction
Shuang QIN ; Dou HUO ; Ruiqing XING ; Xiaoning ZHANG ; Yongchang WU ; Huiyu CHEN ; Daorong PENG
International Journal of Laboratory Medicine 2019;40(2):222-225
Objective To investigate the correction between the levels of vascular endothelial growth factor (VEGF), serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP) and acute cerebral infarction (ACI), and to provide the basis for the diagnosis and treatment of ACI.Methods A total of 76patients with ACI in the hospital from August to October 2017were selected as ACI group.In addition, 32healthy subjects underwent physical examination in the same period in this hospital were selected as negative control group (NC group).The levels of SAA and hs-CRP were detected by nephelometry, while the level of VEGF was measured by enzyme-linked immunosorbent assay (ELISA).The differences of detection indexes between two groups were compared, and the diagnostic value of each index and the combined test were evaluated with the Youden index.Results The levels of SAA, hs-CRP and VEGF in ACI group, were significantly higher than those of NC group (P<0.01).The levels of VEGF was positively correlated with SAA and hs-CRP (r=0.434and0.631, P=0.000and 0.000).The optimal diagnostic critical points of VEGF, SAA and hs-CRP in the diagnosis of ACI were 161.93pg/mL, 3.81mg/L and 4.63mg/L, and the sensitivities were 93.55%, 65.91%and64.44%, the specificities were 60.00%, 93.75%and 90.32%, respectively.Combined detection with hs-CRP and VEGF was superior to single index detection and other joint detection.The sensitivity, specificity and Youden index of combined detection with hs-CRP and VEGF were 96.67%, 95.65%and 0.92respectively.Conclusion The levels of VEGF, SAA and hs-CRP increase in patients with ACI, and they play important roles in the diagnosis of ACI.VEGF are positively related to SAA and hs-CRP, and there may be an synergistic effect exist.VEGF may be involved in the pathological process of cerebral infarction.The combined detection of hs-CRP and VEGF is of high clinical value in the diagnosis of cerebral infarction.
6.Prophylactic value of aggressive hydration with lactated Ringer′s solution during the perioperative period for post-ERCP pancreatitis:a meta-analysis
Junsong YE ; Lian WU ; Daorong CHEN
Chinese Journal of Digestive Endoscopy 2019;36(2):124-130
Objective To evaluate aggressive hydration with lactated Ringer′s solution for prophylaxis of post-ERCP pancreatitis ( PEP ) during the perioperative period. Methods CNKI, VIP, Wangfang,Pubmed,Embase and Cochrane Library were searched for randomized controlled trials( RCTs) on aggressive hydration with lactated Ringer′s solution for preventing PEP published from the setup time of databases to June 2018. According to the inclusion and exclusion criteria, RCTs were selected by two researchers,data were extracted and methodological quality was assessed independently. Revman 5. 3 was used to perform the meta-analysis.The heterogeneity among the included RCTs was analyzed by using the Q test and the chi-square test. The funnel plots,the risk of bias graph and the risk of bias summary were used to evaluate publication bias. Results A total of 10 RCTs with 1727 patients were included. Meta-analysis showed that 10 RCTs had no significant heterogeneity ( P=0. 10, I2 =39%) , aggressive hydration with lactated Ringer′s solution could reduce the incidence of PEP(OR=0. 37,95%CI:0. 26-0. 53,P<0. 00001). Hyperamylasemia incidence was included in 6 RCTs,and the results showed that aggressive hydration with lactated Ringer′s solution could reduce the incidence of hyperamylasemia ( OR=0. 41, 95%CI:0. 27-0. 64, P<0. 00001 ) . A total of 4 RCTs compared the incidence of abdominal pain after ERCP between the experimental group and the control group. Meta-analysis showed that aggressive hydration with lactated Ringer′s solution could reduce the incidence of abdominal pain ( OR=0. 32, 95%CI: 0. 15-0. 68, P=0. 003) . Conclusion Aggressive hydration with lactated Ringer′s solution can effectively prevent PEP and other complications.
7.Surgical site infection following abdominal surgery in China: a multicenter cross-sectional study.
Zhiwei WANG ; Jun CHEN ; Jianan REN ; Peige WANG ; Zhigang JIE ; Weidong JIN ; Jiankun HU ; Yong LI ; Jianwen ZHANG ; Shuhua LI ; Jiancheng TU ; Haiyang ZHANG ; Hongbin LIU ; Liang SHANG ; Jie ZHAO ; Suming LUO ; Hongliang YAO ; Baoqing JIA ; Lin CHEN ; Zeqiang REN ; Guangyi LI ; Hao ZHANG ; Zhiming WU ; Daorong WANG ; Yongshun GAO ; Weihua FU ; Hua YANG ; Wenbiao XIE ; Erlei ZHANG ; Yong PENG ; Shichen WANG ; Jie CHEN ; Junqiang ZHANG ; Tao ZHENG ; Gefei WANG
Chinese Journal of Gastrointestinal Surgery 2018;21(12):1366-1373
OBJECTIVE:
To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China.
METHODS:
The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI.
RESULTS:
A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI.
CONCLUSIONS
The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.
Abdomen
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surgery
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Adult
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Aged
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China
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Cross-Sectional Studies
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Female
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General Surgery
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statistics & numerical data
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Humans
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Male
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Middle Aged
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Operative Time
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Postoperative Complications
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prevention & control
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Preoperative Period
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Retrospective Studies
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Risk Factors
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Surgical Wound Infection
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prevention & control
8.Application value of combined detection of serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in diagnosis of cerebral infarction
Qian ZHAO ; Xiaoning ZHANG ; Tao ZHANG ; Kuangfa LI ; Huiyu CHEN ; Ruiqing XING ; Xiaodong CHENG ; Daorong PENG
International Journal of Laboratory Medicine 2017;38(10):1341-1343,1346
Objective To investigate the correlation between serum lipoprotein-associated phospholipase A2 (LP-PLA2) and homocysteine (Hcy) level change with cerebral infarction,and clinical value of combined detection of serum LP-PLA2,Hcy and blood lipid level in the diagnosis and differentiation diagnosis of cerebral infarction.Methods The serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in sixty-five cases of cerebral infarction(cerebral infarction group) and contemporaneous 64 healthy persons qualified in physical examination(health control group) were selected as the research subjects.The levels of serum LP-PLA2,TG,HDL,LDL,CHO and Hcy were detected.The differences were compared among various groups.Results The TG and LDL levels had no statistically significant difference between the health control group and cerebral infarction group(P>0.05),but the LP-PLA2 and Hcy levels in the cerebral infarction group were higher than those in the health control group(P<0.01),while serum HDL and CHO levels were lower than those in the health control group(P<0.01).Serum High Hcy and LP-PLA2 levels were the independent risk factors for cerebral infarction,however,high HDL was a protective factor for cerebral infarction.In the combined detection,the combined detection of LP-PLA2 and Hcy was superior to single index detection and other combined detection mode.Conclusion Serum LP-PLA2 and Hcy levels in the patients with cerebral infarction are significantly higher than those in the health control group,indicating that it may be involved in the occurrence of cerebral infarction,and may become an early biological marker for predicting cerebral infarction occurrence.The combined detection of serum LP-PLA2 and Hcy has highly clinical value in the diagnosis of cerebral infarction.
9.Diagnostic efficacy of fecal calprotectin on assessing crohn′s disease activity
Jinmin CHEN ; Haoxuan ZHENG ; Zhimin XU ; Tao LIU ; Feihong DENG ; Daorong WANG
Chongqing Medicine 2016;(2):209-211,215
Objective To investigate the diagnostic efficacy of fecal calprotectin(FC) on assessing endoscopic disease activity in colonic or ileo-colonic Crohn disease (CD) and CD-related surgery patients .Methods Totally 56 colonic or ileo-colonic CD pa-tients ,25 CD-related surgery patients and 25 irritable bowel syndrome (IBS) patients with previously confirmed diagnosis of CD and IBS were enrolled into this study .Fecal samples were collected from 1 to 3 day before bowel preparation and FC was measured by ELISA .Endoscopic activity was determined for colonic or ileo-colonic CD with Simple Endoscopic Score for Crohn′s Disease (SES-CD) and CD-related surgery patients with the Rutgeerts′ score .Results Among colonic or ileo-colonic CD patients ,the levels of FC in endoscopic active patients had significantly higher than that of endoscopic remission patients and IBS patients(P < 0 .01) ,there was significant correlation between levels of FC and the SES-CD (r= 0 .802 ,P< 0 .01) .FC threshold of 250 μg/g was tested to in-dicated active endoscopic disease with 97 .1% sensitivity and 71 .4% specificity .Among CD-related surgery patients ,FC level in IBS patients were significantly lower than that of endoscopic remission patients and endoscopic active patients ,but the FC in endoscopic remission patients and endoscopic active patients had no statistic difference(P> 0 .05) ,FC cutoff level of 250 μg /g gave a sensitivity and specificity of 50 .0% ,66 .7% ,respectively .Conclusion FC is a surrogate marker for the evaluation of colonic or ileo-colonic CD endoscopic disease activity .The FC ,however ,can not distinct remission period and active period after CD surgery .
10.Meta Analysis of Dual Antiplatelet Therapy≤6 Months and Dual Antiplatelet Therapy≥12 Months in Patients After Drug-eluting Stent Implantation
Si PANG ; Haibo JIA ; Yaojun ZHANG ; Shunyi SHI ; Daorong PAN ; Xiaoyun CHEN ; Xiaomin REN ; Hao ZHU ; Wen WU ; Shaoliang CHEN
Chinese Circulation Journal 2015;(7):639-643
Objective: To systematically review the safety and efifciency for dual antiplatelet therapy (DAPT) ≤ 6 months and DAPT ≥ 12 months in patients after drug eluting stent (DES) implantation. Methods: We collected the data for randomized clinical trials for DAPT ≤ 6 months and DAPT ≥ 12 months in patients after DES implantation up to 2015-01 by searching the literatures of PubMed, EMBASE, Cochrane Library, Scopus and Chinese literature database, and meanwhile collected the relevant reporting cases from both domestic and international cardiovascular conferences for this study. There were 2 investigators independently conducted the literature screening, data extraction and quality evaluation, Meta analysis was performed with STATA 12.0 software. Results: A total of 15,378 patients from 7 eligible studies were enrolled and the patients were divided into 2 groups: DAPT ≤ 6 months group,n=7672 and DAPT ≥ 12 months group,n=7706. Meta analysis indicated that DAPT ≤ 6 months could effectively reduce the major bleeding (OR=0.58, 95% CI 0.37-0.91,P=0.017). While the other incidences between 2 groups were similar as all cause death (OR=0.90, 95% CI 0.73-1.11,P=0.314), cardiac death (OR=0.93, 95% CI 0.70-1.24,P=0.617), myocardial infarction (OR=1.13, 95% CI 0.91-1.41,P=0.275), in stent thrombosis (OR=1.21, 95% CI 0.79-1.85,P=0.382) and cerebrovascular accidents (OR=1.00, 95% CI 0.66-1.51,P=1.000). Conclusion: The incidence rates of cardiovascular and cerebrovascular events are similar in patients with DAPT ≤ 6 months and DAPT ≥ 12 months after DES implantation. DAPT ≤ 6 month had the lower risk of bleeding, which is rather suitable for the patients received new generation of DES, with higher risk of bleeding, lower risk of thrombosis and with poor compliance to medication; however, the large and randomized clinical trials are needed to make ifnal conclusion.

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