NNIS风险指数在手术部位感染应用的效果评估  

Evaluation of the effect of NNIS risk index on surgical site infections

作　　者：何文英[1] 张焱[1] 黄新玲[1] 李新梅[1] 刘欣[2] 史发林 韩辉[4] 侯铁英[5] 

机构地区：[1]石河子大学医学院第一附属医院院内感染控制办公室,新疆石河子832008 [2]滨州医学院附属医院院内感染控制办公室,山东滨州256603 [3]甘肃省武威肿瘤医院医院感染管理科,甘肃武威733000 [4]山东大学齐鲁医院医院感染管理处,山东济南250012 [5]广东省人民医院检验科,广东广州510080

出　　处：《中华医院感染学杂志》2017年第8期1832-1836,共5页Chinese Journal of Nosocomiology

基　　金：新疆生产建设兵团卫生科技基金资助项目(XJBTWK-201602)

摘　　要：目的评估NNIS风险指数在手术部位感染的应用效果,为NNIS风险调整作参考。方法回顾性收集2014年1月-2016年8月12所医院14 308例手术病例资料,计算不同手术不同NNIS风险组的感染率,应用Spearman秩相关检验分析NNIS风险等级与感染率的相关关系,以受试者工作特征曲线(ROC)下面积(AUC)评价NNIS风险指数对不同手术术后感染的预测能力。结果 NNIS-0、1级、2级、3级感染率分别为1.77%、5.85%、13.13%、26.14%,Spearman秩相关系数为0.642,P<0.01;结直肠切除、开腹胆囊及胆管手术的AUC分别为0.731、0.721、0.717,长骨骨折切开复位内固定、髋关节置换、冠状动脉搭桥、腹式子宫切除的AUC分别为0.634、0.608、0.646、0.623,剖宫产AUC为0.502。结论 NNIS风险指数作为手术部位感染风险分层工具判别能力较好,对感染率高的手术预测能力优于感染率低的手术,如能根据我国的情况对NNIS风险指数进行风险调整或许能够让其作用发挥更有效。OBJECTIVE To evaluate the effect of NNIS risk index on surgical site infections,so as to provide references for NNIS risk adjustment.METHODS The data of 14308 cases in 12 hospitals from Jan.2014 to Aug.2016 were retrospectively analyzed.The infection rates of different operation and different NNIS risk groups were calculated.Spearman rank correlation test was used to analyze the correlation between the NNIS risk grade and infection rate.The area under the receiver operating characteristic（ROC）curve（AUC）was used to evaluate the predictive ability of the NNIS risk index for different postoperative infections.RESULTS The infection rates of NNIS-0,NNIS-1,NNIS-2and NNIS-3were 1.77%,5.85%,13.13% and 26.14%,respectively.The Spearman rank correlation coefficient was 0.642（P〈0.01）.The AUC of overall samples,colorectal resection,and open gallbladder duct surgery were 0.731,0.721,and 0.717,respectively.The AUC of long bone fracture fixation,hip replacement,coronary artery bypass and abdominal hysterectomy were 0.634,0.608,0.646,and 0.623,respectively,and the AUC of cesarean section was 0.502.CONCLUSIONNNIS risk index has good discrimination ability as a surgical site infection risk stratification tool,its predictive ability of operation with a high infection rate is better than that with a low infection rate.If we can adjust the NNIS risk index according to the situation of our country,we may make its role more effective.

关 键 词：手术部位感染 NNIS风险指数 风险预测 

分 类 号：R619.3[医药卫生—外科学]