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新生儿出生后早期手术与手术部位感染的低风险相关。

Early postnatal neonatal surgery is associated with a low risk of surgical site infections.

作者信息

Koike Yuhki, Higashi Koki, Sato Yuki, Yamashita Shinji, Nagano Yuka, Kitajima Takahito, Shimura Tabanobu, Matsushita Kohei, Okita Yoshiki, Okugawa Yoshinaga, Ogura Toru, Toiyama Yuji

机构信息

Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.

Department of Cancer Genome, Mie University Graduate School of Medicine, Tsu, Mie, Japan.

出版信息

Surg Today. 2025 May 18. doi: 10.1007/s00595-025-03060-8.

Abstract

PURPOSE

Despite the recognition of the negative effects of surgical site infection (SSI), data on neonatal surgery are limited. This study investigated the risk factors for SSI development in the neonatal period.

METHODS

Neonatal surgeries performed by pediatric surgeons at the Mie University Hospital between 2007 and 2023 were retrospectively reviewed. The correlation between age at surgery and the presence of SSI was analyzed, and the optimal cutoff value for age at surgery was determined with respect to SSI. The predictors of SSI were analyzed using a logistic regression analysis.

RESULTS

Among 272 neonatal surgeries, SSI was identified in 19 patients (7.0%). Patients with SSI were significantly older than those without SSI (P = 0.003), and the optimal cut-off value was age > 3 days. The incidence rate of SSI was 2.05% in the ≤ 3-day-old group and 12.7% in the > 3 day-old group (P < 0.001). A multivariate analysis revealed that intestinal perforation, preoperative elevated C-reactive protein (CRP) level, and surgery at > 3 days old were independent predictors of SSI.

CONCLUSION

Intestinal perforation, preoperative elevated CRP, and surgery after 3 days old are associated with an increased SSI risk in neonatal surgery.

摘要

目的

尽管已认识到手术部位感染(SSI)的负面影响,但关于新生儿手术的数据有限。本研究调查了新生儿期发生SSI的危险因素。

方法

回顾性分析2007年至2023年期间三重大学医院小儿外科医生进行的新生儿手术。分析手术时年龄与SSI发生之间的相关性,并确定手术时年龄关于SSI的最佳临界值。使用逻辑回归分析来分析SSI的预测因素。

结果

在272例新生儿手术中,19例患者(7.0%)被确诊为SSI。发生SSI的患者比未发生SSI的患者年龄显著更大(P = 0.003),最佳临界值为年龄>3天。≤3日龄组的SSI发生率为2.05%,>3日龄组为12.7%(P < 0.001)。多因素分析显示,肠穿孔、术前C反应蛋白(CRP)水平升高以及手术时年龄>3天是SSI的独立预测因素。

结论

肠穿孔、术前CRP升高以及3天后手术与新生儿手术中SSI风险增加相关。

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