Surgical infections最新文献_第9页

Ventilator-Associated Pneumonia Predicts Severe Cognitive Disability in Severe Traumatic Brain Injury. 呼吸机相关性肺炎可预测严重创伤性脑损伤患者的严重认知障碍。

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-03 DOI: 10.1089/sur.2024.208

Shruthi Srinivas, Kelly Nahum, Christopher Gilliam, William Brigode, Stephanie Doris, Tanya Egodage, Michelle Kincaid, Anna Liveris, Katherine McBride, Kaushik Mukherjee, Philip Edmundson, Liz Penaloza-Villalobos, Jacob W Roden-Foreman, Joy Song, Johanna Stecher, Anthony Tigano, Brett Tracy

{"title":"Ventilator-Associated Pneumonia Predicts Severe Cognitive Disability in Severe Traumatic Brain Injury.","authors":"Shruthi Srinivas, Kelly Nahum, Christopher Gilliam, William Brigode, Stephanie Doris, Tanya Egodage, Michelle Kincaid, Anna Liveris, Katherine McBride, Kaushik Mukherjee, Philip Edmundson, Liz Penaloza-Villalobos, Jacob W Roden-Foreman, Joy Song, Johanna Stecher, Anthony Tigano, Brett Tracy","doi":"10.1089/sur.2024.208","DOIUrl":"https://doi.org/10.1089/sur.2024.208","url":null,"abstract":"Background: Ventilator-associated pneumonia (VAP) is linked to poor outcomes in patients with severe traumatic brain injury (TBI), yet its effect on cognitive disability is unknown. We hypothesized that there would be an association between severe cognitive disability and VAP in this patient population. Methods: We performed a post hoc analysis of a prospective, multi-center, observational study of adults with a severe, blunt TBI from 2020 to 2023. Patients were grouped by whether they developed VAP. Our primary outcome was severe cognitive disability, defined as a disability rating scale (DRS) score >13 at discharge (or 28 days post-injury if not discharged). Results: There were 309 patients in the cohort; 31.7% (n = 98) developed VAP. The VAP group had greater incidences of diffuse axonal injury (37.3% vs. 22.3%, p = 0.004), neurosurgical interventions (63.3 vs. 38.4%, p < 0.001), and tracheostomies (72.5% vs. 28.9%, p < 0.001). Patients with VAP had a longer duration of mechanical ventilation (13 d vs. 3 d, p < 0.001). Among patients with VAP, median time to diagnosis was 7 days (4-12), time to tracheostomy was 10 days (7-16), and time between the two events was 4 days (2-11). Greater proportions of cognitive disability (64.3% vs. 19.9%, p < 0.001) and worse median DRS scores (8 vs. 2, p < 0.001) occurred in the VAP group. On multi-variable regression analysis, VAP was an independent risk factor for severe cognitive disability (adjusted odds ratio [aOR]: 4.2, 95% CI: 2.2-7.8). Conclusion: Ventilator-associated pneumonia is common among patients with a severe TBI and is a risk factor for severe cognitive disability. Adherence to VAP prevention techniques may help mitigate cognitive impairment in this population.","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

30-Day Readmissions and the Need for Emergency Surgery Following Non-Operative Management of Perforated Diverticulitis. 非手术治疗穿孔性憩室炎后的 30 天再入院率和急诊手术需求。

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-01 Epub Date: 2024-10-22 DOI: 10.1089/sur.2024.101

Joshua Gazzetta, Alyssa Fesmire, Rita Orjionwe, Leo Andrew Benedict, Sean Nix

{"title":"30-Day Readmissions and the Need for Emergency Surgery Following Non-Operative Management of Perforated Diverticulitis.","authors":"Joshua Gazzetta, Alyssa Fesmire, Rita Orjionwe, Leo Andrew Benedict, Sean Nix","doi":"10.1089/sur.2024.101","DOIUrl":"10.1089/sur.2024.101","url":null,"abstract":"Background: Limited data are available on the evaluation and outcomes of patients with perforated diverticulitis who were treated without surgery. Aims: This retrospective review was aimed at investigating the 30-day non-elective re-admission rates for patients hospitalized with perforated diverticular disease who were treated without surgery, rates of patients requiring surgery on re-admission, and the independent predictors of re-admission. Methods: A total of 143,546 patients from the National Readmission Database, between 2016 and 2020, who were admitted with perforated diverticulitis and treated non-operatively were reviewed. Re-admitted patients were compared with those not re-admitted. Comparisons for continuous and categoric variables were made using the student t-test and chi-squared test, respectively. A logistic regression model was used to determine independent factors associated with re-admission. All analyses were done with SAS 9.4; p values <0.05 identified significance. Results: Among patients with perforated diverticulitis who were treated non-operatively, 17,868 (12.4%) were re-admitted within 30 days and 4,924 (27.6%) of patients re-admitted required surgical intervention. The greatest independent predictors of re-admission include patient insurance status, index length of stay, undergoing a drainage procedure, and patient disposition. Comorbidities predicting re-admission include renal failure, chronic pulmonary disease, diabetes mellitus, fluid and electrolyte disorders, and hypertension. Hospital total charges were greater at the index admission for patients requiring re-admission. Conclusion: Non-operative management of perforated diverticulitis is safe for many patients, but the risks for re-admission and subsequent need for emergency surgery require special consideration.","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"1-5"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unveiling Therapeutic Challenges: A Unique Case of Intracranial Myroides odoratimimus Infection Following Hemorrhagic Stroke. 揭示治疗难题：出血性中风后颅内糠秕孢子菌感染的独特病例。

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-01 Epub Date: 2024-10-22 DOI: 10.1089/sur.2024.215

Yosr Kadri, Oumayma Belhouane, Ons Haddad, Yassmine Maatouk, Ahmed Daoued, Kais Maamri, Mehdi Darmoul, Maha Mastouri

引用次数: 0

Predictive Value of Red Blood Cell Distribution Width-to-Platelet Ratio for Severity in Pyogenic Liver Abscess: A Retrospective Observational Study. 红细胞分布宽度与血小板比值对化脓性肝脓肿严重程度的预测价值：一项回顾性观察研究

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-01 Epub Date: 2024-10-22 DOI: 10.1089/sur.2024.068

Yunxiao Lyu, Hao Wang, Zhuojun Zhong, Bin Wang

{"title":"Predictive Value of Red Blood Cell Distribution Width-to-Platelet Ratio for Severity in Pyogenic Liver Abscess: A Retrospective Observational Study.","authors":"Yunxiao Lyu, Hao Wang, Zhuojun Zhong, Bin Wang","doi":"10.1089/sur.2024.068","DOIUrl":"10.1089/sur.2024.068","url":null,"abstract":"Background: The ratio of red blood cell distribution width (RDW) to platelet ratio (RPR) may have prognostic value in several inflammation-related diseases. However, few studies have been conducted on the value of RPR for predicting the severity of pyogenic liver abscess (PLA). Methods: Patients receiving the diagnosis of PLA from February 2013 to December 2022 were enrolled in this retrospective study. We collected data related to baseline characteristics and laboratory results within the first 24 hours the of admission. The receiver operating characteristic curve and the area under the curve (AUC) were used to evaluate the predictive ability of different indicators for severity in PLA. Results: A total of 278 patients were enrolled. For the prediction of sepsis in PLA, RPR had the highest AUC (0.83; 95% confidence interval [CI], 0.78-0.89) with a sensitivity of 0.78 and specificity of 0.82. For the prediction of septic shock, RPR also had the highest AUC (0.74; 95% CI, 0.60-0.88) with a sensitivity of 0.67 and specificity of 0.79. The best cutoff value for RPR to predict sepsis was 0.08 and to predict septic shock was 0.11. Conclusions: An increase in RPR level serves as a useful indicator with a predictive capacity for severity in PLA.","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"33-38"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor: The Great Masquerader: Pulmonary Paragonimiasis. 伟大的伪装者肺旁膜炎

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-01 Epub Date: 2024-10-24 DOI: 10.1089/sur.2024.191

Bo Sun, Jiaqi Deng, Rong Kuang, Jing Zhou

引用次数: 0

Impact of an Acute Care Surgery Clinical Pathway on Patient Outcomes in Acute Appendicitis. 急诊外科临床路径对急性阑尾炎患者预后的影响。

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-01 Epub Date: 2024-11-06 DOI: 10.1089/sur.2024.100

Naima Islam, Garima Thakkar, Celeste Ferguson, Kevin Kennedy, Nicholas Bennett, Tolulope Oyetunji, Alyssa Fesmire, Josh Gazzetta, Dennis Arce, Tammy Neblock-Beirne, Sean Nix, Leo Andrew O Benedict

{"title":"Impact of an Acute Care Surgery Clinical Pathway on Patient Outcomes in Acute Appendicitis.","authors":"Naima Islam, Garima Thakkar, Celeste Ferguson, Kevin Kennedy, Nicholas Bennett, Tolulope Oyetunji, Alyssa Fesmire, Josh Gazzetta, Dennis Arce, Tammy Neblock-Beirne, Sean Nix, Leo Andrew O Benedict","doi":"10.1089/sur.2024.100","DOIUrl":"10.1089/sur.2024.100","url":null,"abstract":"Objectives: Acute care surgery (ACS) encompasses surgical critical care, emergency general surgery, and the surgical management of trauma. Following ACS implementation at our institution, we developed a perioperative clinical pathway for acute appendicitis (AA) to improve efficiency and standardize post-operative care. The purpose of our study is to assess patient outcomes utilizing our ACS clinical pathway for patients with AA. Methods: This is a retrospective cohort study involving patients admitted to our tertiary care facility with AA who underwent appendectomy. Patients were classified by pre-implementation (January 1, 2016-July 31, 2018) and post-implementation (August 1, 2018-December 31, 2020) of our ACS clinical pathway. The primary outcome was hospital length of stay (LOS). Statistical analysis was performed using SAS with a p-value <0.05 determined as significant. Results: Of the 492 patients included, 225 were in the pre- and 267 were in the post-implementation cohorts. Hospital LOS was substantially decreased in the post-implementation cohort (31.2 vs. 50.4 h, p < 0.001). The post-implementation group had a substantial decrease in computed tomography (CT) to operating room (OR) start time (6.81 vs. 11.4 h, p < 0.001), CT to antibiotic agents' administration (2.20 vs. 3.37 h, p < 0.001), inpatient opioid utilization (125 morphine equivalents [ME] vs. 172 ME, p < 0.001), and discharge antibiotic agents' prescription rates (23.6% vs. 30.7%, p = 0.077). Recovery unit discharges (20 vs. 9%, p < 0.001) were increased in the post-implementation cohort. Conclusion: Our ACS clinical pathway for AA resulted in earlier surgical intervention, enhanced opioid and antimicrobial stewardship, and gains in surgical care efficiencies.","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"11-16"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Different Clinical Characteristics of Right-Sided Versus Left-Sided Colonic Diverticular Complications: A Four-Year Retrospective Study in a Chinese Population. 右侧与左侧结肠憩室并发症的不同临床特征：一项为期四年的中国人群回顾性研究。

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-01 Epub Date: 2024-11-06 DOI: 10.1089/sur.2024.132

Qi Gao, Jia-Yuan Peng, Yue-Qing Bai, Xiao-Er Wei, Zhong-Nan Li

{"title":"Different Clinical Characteristics of Right-Sided Versus Left-Sided Colonic Diverticular Complications: A Four-Year Retrospective Study in a Chinese Population.","authors":"Qi Gao, Jia-Yuan Peng, Yue-Qing Bai, Xiao-Er Wei, Zhong-Nan Li","doi":"10.1089/sur.2024.132","DOIUrl":"10.1089/sur.2024.132","url":null,"abstract":"Aim: To determine whether right-sided and left-sided colonic diverticular complications have different clinical manifestations and treatment outcomes. Methods: Patients diagnosed with diverticulitis or diverticular hemorrhage from January 2019 to December 2023 were retrieved. Patients were assigned into the right-sided group and the left-sided group according to the colon affected by diverticular complications. For each patient, age, gender, body mass index (BMI), lifestyle, clinical presentation, and concomitant medication were recorded. Clinical characteristics and treatment outcomes were compared with between the two groups. Results: A total of 123 patients were included in this study, 89 in the right-sided group and 34 in the left-sided group. Patients in the right-sided group presented a significantly lower mean age (43.33 vs. 66.35 yrs old, p < 0.0001) and a smaller proportion of patients with BMI above 25 (10.11% vs. 24.76%, p = 0.02). Left-sided group diverticulitis had a significantly higher proportion of Hinchey III to IV (29.41% vs. 1.12%, p = 0.0001) and rate of intensified conservative treatment (30.77% vs. 2.38%, p = 0.0003). Patients in the left-sided group had a higher rate of crowding of diverticula (diverticular number counted >20) (35.29% vs. 1.12%, p < 0.01). Two patients in the right-sided group and eight in the left received laparotomy because of diverticulitis. All three cases of hemorrhage were in the right-sided group. Conclusion: Compared with the left, right-sided diverticulosis is characterized by a younger age, less-virulent diverticulitis, and potentially higher hemorrhagic propensity. Different mechanisms between the groups may exist to mediate the onset and development of diverticulosis and its complications.","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"6-10"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the Editor: Is There a Good Prognostic Score to Detect Risk of Sternal Wound Infection after Coronary Artery Bypass Surgery? 简短报告：是否有良好的预后评分来检测冠状动脉搭桥手术后胸骨伤口感染的风险？

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-01 Epub Date: 2024-09-26 DOI: 10.1089/sur.2024.206

Chloé Bernard, Ludwig Serge Aho Glele

引用次数: 0

Letter to the Editor: Migration of Fish Bone Foreign Bodies into Thyroid and Common Carotid Artery. 鱼骨异物移入甲状腺和颈总动脉

IF 1.4 4区医学

Surgical infections Pub Date : 2025-02-01 Epub Date: 2024-11-04 DOI: 10.1089/sur.2024.168

Rong Kuang, Bo Sun, Qiaohong Wei, Jiaqi Deng, Xiaomei Chen

引用次数: 0

Acknowledgment of Reviewers 2024. 审稿人致谢