使用国家医疗保健安全网络(NHSN)数据以及使用行政数据可用的诊断代码来识别腹腔子宫切除术(HYST)后手术部位感染(SSIs)的风险因素。我们分析了2015年1月至2018年12月之间在166家纽约州医院中报告在NHSN中的66001例HYST手术，并与结算数据匹配。通过逻辑回归模型，确定了腹腔子宫切除术后SSI的风险因素。共分析了66001例HYST手术。1,093例手术后报告了SSI，感染率为1.66％。与SSI相关的风险因素包括开放式手术(非腹腔镜)的调整后比值(odds ratio, AOR)为2.72，95％置信区间(confidence interval, CI)为2.37-3.12; 受污染或脏类伤口的等级(AOR 2.28, 95％ CI 1.61-3.24); 身体质量指数≥30(AOR 1.78, 95％ CI 1.56-2.02); 持续186分钟或更长时间的程序(AOR 1.78, 95％ CI 1.56-2.02); 美国麻醉学会(ASA)评分≥3(AOR 1.74, 95％ CI 1.52-1.99); 妇科癌症(AOR 1.54, 95％ CI 1.32-1.80); 糖尿病(AOR 1.46, 95％ CI 1.24-1.70)。肥胖、程序持续时间过长、糖尿病、创口污染、开放式手术、ASA评分≥3和妇科癌症是腹腔子宫切除术后SSI的重要独立风险因素。版权所有©2023 Elsevier Inc.发表。

To identify risk factors for surgical site infections (SSIs) after abdominal hysterectomy (HYST) procedures using National Healthcare Safety Network (NHSN) data augmented with diagnosis codes available using administrative data.We analyzed 66,001 HYST procedures in 166 New York State hospitals between January 2015 and December 2018, reported in NHSN, and matched to billing data. Risks factors for SSI after abdominal hysterectomy were identified using logistic regression models.A total of 66,001 HYST procedures were analyzed. SSI was reported following 1,093 procedures, resulting in an infection rate of 1.66%. Risk factors associated with SSIs were open approach (not laparoscopic) with an adjusted odds ratio (AOR) of 2.72 and 95% confidence interval (CI) of 2.37-3.12, contaminated or dirty wound class (AOR 2.28, 95% CI 1.61-3.24), body mass index ≥30 (AOR 1.78, 95% CI 1.56-2.02), procedures lasting 186 minutes or more (AOR 1.78, 95% CI 1.56-2.02), American Society of Anesthesia (ASA) score ≥3 (AOR 1.74, 95% CI 1.52-1.99), gynecological cancer (AOR 1.54, 95% CI 1.32-1.80), and diabetes mellitus (AOR 1.46, 95% CI 1.24-1.70).Obesity, prolonged procedure duration, diabetes mellitus, wound contamination, open approach, ASA score ≥3, and gynecological cancer were significant independent risk factors associated with SSI after hysterectomy.Copyright © 2023. Published by Elsevier Inc.