기본간호학회지 (Journal of Korean Academy of Fundamentals of Nursing)

  • 제21권2호
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  • Pages.151-161
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  • 2014
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  • 1225-9012(pISSN)
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  • 2287-1802(eISSN)
기본간호학회 (Korean Academy of Fundamentals of Nursing)
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전자의무기록(EMR) 자료를 활용한 수술부위감염 관련요인

Risk Factors for Surgical Site Infections According to Electronic Medical Records Data

  • 투고 : 2014.02.16
  • 심사 : 2014.05.07
  • 발행 : 2014.05.31
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초록

Purpose: The purpose of this study was to identify the risk factors that influence surgical site infections after surgery. Methods: This study was a retrospective research utilizing Electronic Medical Records. Data collection targeted 4,510 adult patients who had 8 different kinds of surgery (gastric surgery, colon surgery, laparoscopic cholecystectomy, hip & knee replacement, hysterectomy, cesarean section, cardiac surgery) in 4 medical care departments, at one general hospital between January 2006 and December 2011. Multivariate logistic regression analyses were used to identify the risk factors affecting surgical site infections after surgery. Results: Risk factors for increased surgical site infection following surgery were confirmed to be age (OR=1.59, p<.001), BMI (Body Mass Index)(OR=1.25, p=.034), year of operation (OR=2.45, p<.001), length of operation (OR=3.06, p<.001), ASA (American Society of Anesthesiology) score (OR=1.36, p=.025), classification of antibiotic used (OR=2.77, p<.001), duration of the prophylactic antibiotics use (OR=1.85, p<.001), and interaction between classification of antibiotic used and duration of the prophylactic antibiotics use (OR=1.90, p=.016). Conclusions: Results suggest that risk factors affecting surgical site infections should be monitored before surgery. The results of this study should contribute to establishing effective infection management measures and implementing surveillance systems for patients who have actual risk factors.

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참고문헌

  1. Ahn, Y. J., & Sohng, K. Y. (2005). Factors related to surgical site infections in patients undergoing general surgery. Journal of Korean Academy of Fundamentals of Nursing, 12, 113-120.
  2. Anderson, D. J., Kirkland, K. B., Kaye, K. S., Thacker, P. A., Kanafani, Z. A., Auten, G., et al. (2007). Underresourced hospital infection control and prevention program: Penny wise, pound foolish?. Infection Control and Hospital Epidemiology, 28, 767-773. http://www.jstor.org/stable/10.1086/518518
  3. Bratzler, D. W., & Houck, P. M. (2005). Antimicrobial prophylaxis for surgery: An advisory statement from the National Surgical Infection Prevention Project. American Journal of Surgery, 189, 395-404. http://dx.doi.org/10.1016/j.amjsurg.2005.01.015
  4. Cha, K. S., Cho, O. H., & Yoo, S. Y. (2010). Risk factors for surgical site infection in patients undergoing craniotomy. Journal of Korean Academy of Nursing, 40, 298-305. http://dx.doi.org/10.4040/jkan.2010.40.2.298
  5. Chang, J. S., Kim, Y. S., Shon, H. C., Kim, J. W., Chung, S. Y., & Park, J. H. (2005). Short-term prophylactic antibiotics in total hip arthroplasty. Journal of the Korean Orthopaedic Association, 40, 428-433. https://doi.org/10.4055/jkoa.2005.40.4.428
  6. Health Insurance Review and Assessment Service. (2010). 2009 based on quality assessment data in Korea. Seoul: Author.
  7. Idali, B., Lahyat, B., Khaleq, K., Ibahioin, K., Azhari, E. I., & Barrou, L. (2004). Postoperative infection following craniotomy in adults. Medicine et maladies infectieuses, 34, 221-224. http://dx.doi.org/10.1016/j.medmal.2003.12.011
  8. Jeong, Y. I., Mun, S. P., Chang, J. H., Kim, K. C., Min, Y. D., Kim, S. H., et al. (2008). The risk factors associated with surgical site infection after an abdominal operation. Journal of Korean Surgical Society, 75, 177-183.
  9. Jo, H., Park,. C. H., & Kim, H. O. (2001). Gerontological nursing. Secoul: Hyunmoonsa.
  10. Kim, K. H., Park, C. S., Chang, J. H., Kim, N. S., Lee, J. S., Choi, B. R., et al. (2010). Association between prophylactic antibiotic use and surgical site infection based on quality assessment data in Korea. Journal of Preventive Medicine and Public Health, 43, 235-244. http://dx.doi.org/10.3961/jpmph.2010.43.3.235
  11. Kim, M. S. (2011). Risk factors for surgical site infection after major oncological surgery for head and neck cancer. Unpublished doctoral dissertation, Chung-Ang University, Seoul.
  12. Kim, S. H. (2007). Evaluation of prophylactic antibiotic use in surgery. Unpublished master's thesis, Ewha womans university, Seoul.
  13. Korean Society for Nosocomial Infection Control. (2011). Korea society for nosocomial infection control. Seoul: Hanmibook.
  14. Korinek, A. M., Golmard, J. L., Elcheick, A., Bismuth, R., Van Effenterre, R., Coriat, P., et al. (2005). Risk factors for neurosurgical site infections after craniotomy: A critical reappraisal of antibiotic prophylaxis on 4,578 patients. British Journal of Neurosurgery, 19, 155-162. http://dx.doi.org/10.1080/02688690500145639
  15. Kourbeti, I. S., Jacobs, A. V., Koslow, M., Karabetsos, D., & Holzman, R. S. (2007). Risk factors associated with postcraniotomy meningitis. Neurosurgery, 60, 317-325. http://dx.doi.org/10.1227/01.NEU.0000249266.26322.25
  16. Lee, S. Y., Kim, S. D., Lee, J. S., & Lee, K. H. (2007). Risk factors for surgical site infection among patients in a general hospital. Korean Journal of Nosocomial Infection Control, 12, 9-20.
  17. Lietard, C., Thebaud, V., Besson, G., & Lejeune, B. (2008). Risk factors for neurosurgical site infections: An 18-month prospective survey. Journal of Neurosurgery, 109, 729-734. http://dx.doi.org/10.3171/JNS/2008/109/10/0729
  18. Ministry of Health and Welfare. (2005). The management of nosocomial infection. Retrived March 31, 2005, from Web site: http://www.mw.go.kr
  19. Mortazavi, S. M. Schwartzenberger, J., Austin. M. S., Purtill., J. J., & Parvizi, J. (2010). Revision total knee arthroplasty infection: Incidence and predictors. Clinical Orthopaedics and Related Research, 468, 2052-2059. http://dx.doi.org/10.1007/s11999-010-1308-6
  20. National Institute for Health and Clinical Excellence. (2008). Surgical site infection: NICE clinical guideline 74. Retrieved October, 2008, from Web site: http://www.nice.org.uk/guidance/CG74
  21. Park, E. S., Kim, K. S., Lee, W. J., Jang, S. Y., Choi, J. Y., & Kim, J. M. (2005). Economical impacts of surgical site infections. Korean Journal of Nosocomial Infection Control, 10, 57-64.
  22. Polk, H. C., & Lopez-Mayor, J. F. (1969). Postoperative wound infection: A prospective study of determinant factors and prevention. Surgery, 66, 97-103.
  23. Sakong, P., Lee, J. S., Lee, E. J., Ko, K. P., Kim, C. H., Kim, Y., et al. (2009). Association between the pattern of prophylactic antibiotic use and surgical site infection rate for major surgeries in Korea. Journal of Preventive Medicine and Public Health, 42, 12-20. http://dx.doi.org/10.3961/jpmph.2009.42.1.12
  24. Song, E. K., Yoon, T. R., Park, S. J., Park, K. S., & Jung, W. B. (2009). Protocol for administration of prophylactic antibiotics within one hour before the surgical incision in total hip and knee replacement. Journal of Korean Orthopedic Association, 44, 159-164. https://doi.org/10.4055/jkoa.2009.44.2.159
  25. Song, K, H. (2009). Risk factors of infection after thoracic and lumbar spinal Arthrodesis. Unpublished master's thesis, Chonbuk National University, Kwangju.
  26. Van Kasteren, M. E., Mannien, J., Ott, A., Kullberg, B. J., de Boer, A. S., & Gyssens, I. C. (2007). Antibiotic prophylaxis and the risk of surgical site infections following total hip arthroplasty: Timely administration is the most important factor. Clinical Infections Diseases, 44, 921-927. http://dx.doi.org/10.1086/512192.

피인용 문헌

  1. Neurosurgical Infection Rates and Risk Factors: A National Surgical Quality Improvement Program Analysis of 132,000 Patients, 2006–2014 vol.97, 2017, https://doi.org/10.1016/j.wneu.2016.09.056