Incidencia y factores de riesgo de infección nosocomial de herida quirúrgica en Neurocirugía
Incidence and risk factors of surgical site infections in Neurosurgery
J. Martínez Checa, J. Planes Martínez, P. González de la Flor, M.A. Fernández Sierra, E. Jiménez Romano, A. Cordero Moreno
Servicio de Medicina Preventiva. Hospital Universitario Virgen de las Nieves. Granada
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"apellidos" => "González de la Flor" ] 3 => array:2 [ "nombre" => "M.A." "apellidos" => "Fernández Sierra" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Jiménez Romano" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Cordero Moreno" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Medicina Preventiva. Hospital Universitario Virgen de las Nieves. Granada" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Incidence and risk factors of surgical site infections in Neurosurgery" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec156891" "palabras" => array:3 [ 0 => "Nosocomial infection" 1 => "Risk factors" 2 => "Neurosurgery" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Palabras Clave" "identificador" => "xpalclavsec156892" "palabras" => array:3 [ 0 => "Infección nosocomial" 1 => "Factores de riesgo" 2 => "Neurocirugía" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la incidencia de infección nosocomial global del foco quirúrgico y según localización de la intervención. Analizar factores de riesgo de infección nosocomial y comprobar si en nuestros enfermos es válido el índice de riesgo del estudio NNIS.</p> <span class="elsevierStyleSectionTitle">Pacientes y Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realizó un estudio de cohortes prospectivo en el Servicio de Neurocirugía que abarcó desde el 1 de Octubre de 1995 al 31 de Mayo de 1998. Se incluyeron todos los enfermos con intervenciones neuroquirúrgicas realizadas en este período de tiempo, en total 1.956 pacientes, para los que se realizó un seguimiento de treinta días tras la intervención. Los enfermos se agruparon en cuatro tipos de cirugía: cráneo, columna, shunt ventricular (SV) y otras. Se siguieron los criterios de ipfección nosocomial establecidos por los CDC en 1992.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La incidencia total de infección de herida quirúrgica resultó del 3.7%. En craneotomías esta incidencia fue del 4.2%, en intervenciones de columna del 3.6%, en SV del 4.3% y en otro tipo de cirugía neuroquirúrgica del 0%. Los factores de riesgo en el análisis multivariable mediante regresión logística múltiple fueron, para las intervenciones de cráneo: tiempo quirúrgico de intervención superior al tiempo T (valorado por el estudio NNIS) y una intervención neuroquirúrgica realizada en los treinta días precedentes; para las intervenciones de columna los factores de riesgo fueron: tiempo quirúrgico de intervención superior al tiempo T y el grado de contaminación de la herida quirúrgica en el grupo de contaminadasucia. Se agrupó a los pacientes sometidos a craneotomía e intervención de columna según su índice de riesgo NNIS, obteniéndose resultados muy significativos.</p> <span class="elsevierStyleSectionTitle">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La incidencia de infección global de la herida quirúrgica es similar a los porcentajes hallados en la bibliografía consultada, que está comprendida entre el 0.96% y el 5.70%. La incidencia de infección nosocomial de herida quirúrgica según la localización de la intervención se encuentra también dentro de las cifras aportadas por la literatura. Los factores de riesgo independientes encontrados son: tiempo quirúrgico de intervención, el grado ASA y la reintervención. Se validó en este estudio el índice de riesgo NNIS.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To establish the incidence of nosocomial infection of the surgical wound, both total and by location of the surgical intervention. To identify the risk factors of nosocomial infection and to analyze the validity of the risk index of the NNIS Study in patients at our hospital.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A prospective cohort study was carried out in the Department of Neurosurgery, from 1st October 1995 to 31<span class="elsevierStyleSup">st</span> May 1998. All patients undergoing a neurosurgical intervention during this period were included (1956 patients) and followed through 30 days after surgical intervention. Patients were classified in four groups according to the type of procedure: craniotomy, spinal procedures, shunt piacement, and other. The criteria established by the CDC in 1992 for nosocomial infection were used.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The incidence rate of infection of the surgical wound was 3.7%. The incidence rates of nosocomial infection by the type of procedure were: 4.2% in craniotomy, 3.6% in spinal procedures, 4.3% in shunt placement and 0 in other neurosurgical procedures.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The risk factors identifled in the muItivariate analysis (logistic regression) were: 1) For craniotomy: time of the surgical intervention longer than time T (standard according to the NNIS Study), and having a neurosurgical intervention in the previous month; 2) for surgical procedures of the spine: time of the surgical intervention longer than time T and high level of contamination of the surgical wound (contaminated-dirty). Patients who had had a surgical intervention concerning either craniotomy or spinal procedure were classified by the risk index of the NNIS Study, obtaining a statistically significative correlation.</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The incidence rate of infection of the surgical wound found in this study is similar to the incidence rate reported in other studies (range from 0.96% to 5.70%). The incidence rate of nosocomial infection of the surgical wound by location is also into the range reported in the Iiterature. The independent risk factors identified were: the duration of the surgical intervention, the ASA level and previous neurosurgery in the preceding month. The risk index of the NNIS Study was found to be valid in our hospital context.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Martínez Checa, J.; Planes Martínez, J; González de la Flor, P.; Fernández Sierra, M.A.; Jiménez Romano, E.; Cordero Moreno, A.: Incidencia y factores de riesgo de infección nosocomial de herida quirúrgica en Neurocirugía. Neurocirugía 2000; 11: 103–109.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infecciones quirúrgicas: Heridas incisionales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.A. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Julio | 1 | 0 | 1 |
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| 2017 Junio | 23 | 36 | 59 |
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| 2017 Marzo | 15 | 38 | 53 |
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