A case-control study on risk factors for postoperative nosocomial infections in patients with orthopedics operation / 预防医学

ABSTRACT

Objective To determine the risk factors of postoperative nosocomial infections (NI) in patients of orthopedics department of a PLA hospital, in order to provide the theory basis for prevention and control of postoperative nosocomial infections in patients of orthopedics department. Methods Using the real-time nosocomial infection surveillance system, we selected and retrospectively reviewed the patients after orthopedics operation and the patients with postoperative NI from Jan. 2013 to Dec. 2015. A 1:1 matched case-control study was carried out. Controls were patients with the same period of hospitalization, the same department, the same sex and age difference of 5 years old, the same main diagnosis without NI. The data were analyzed using conditional logistic regression. Results In the survey of 13134 patients after orthopedics operation, there were 91 patients with postoperative NI and the infection rate was 0.69％. Multiple logistic regression analysis showed that who had admitted to the ICU (OR=103.128, 95％ CI: 1.470-7237.388) , with a high level of incision contamination (OR=24.097, 95％ CI: 1.428-406.725) , perioperative use of antimicrobial for prophylactic utilization (OR=12.534, 95％ CI:3.460-45.407) and using hormones before nosocomial infection (OR=6.872, 95％CI: 1.374-34.384) was a risk factor for postoperative NI. Conclusion The postoperative NI in patients of orthopedics department was at a low level, and patients who had admitted to the ICU, with a high level of incision contamination, irrational perioperative use of antimicrobial agents, using hormones before nosocomial infection will increase the incidence of postoperative NI.