Independent Risk Factors Assessment On Orthopaedic Joint Replacement Surgical Site Infection And Explorative Study On Building The Infection Risk Prediction System

Background and ObjectiveSurgical site infection is a common postoperative complications of surgery. A high incidence of postoperative infection will occur after joint replacement surgery. The prevention and control of operation site infection also a important work of clinical pharmacists. The consequences of infection maybe lead to reoperation, disability even death. The purpose of this study is to prevent infection by screening independent risk factors for SSI in joint replacement surgery and set up SSI prediction system.Method1Data100cases of patients with orthopaedic joint replacement surgery were randomly selected from January to December in2013.Then the SSI Risk Factors Questionnaire was designed. The information risk factors assessment by SSI Risk Factors Questionnaire.2Data analysisSPSS19.0was adopted to process the data.The x2test was used to evaluate the correlation between variables and surgical site infection, and P<0.1was considered to be statistically significant. To screen out the independent risk factors,a multivariable forward logistic regression analysis was used.When P≤0.05, the variable was entered in the model; if P>0.1, the variable was removed.3The SSI prediction system establishmentJoint replacement surgery SSI prediction system was established by assignment to independent risk factors. The system was compared with NNIS and SENIC systems by the ROC curve to verify its accuracy.Result1The SSI independent risk factors for orthopaedic joint replacement surgeryThis study investigated the100cases in orthopaedic joint replacement surgery, including50cases of total hip replacement,40cases of hip replacement,10cases of total knee arthroplasty. Among100cases,14patients were diagnosed with SSI.36patients were male and64patients were female. The average age of the patients was69.29±11.91. The7independent risk factors for surgical site infection included age>65(OR5.736;95%CI1.228-73.438), cancer (OR1.53*109;95%CI0-), preoperative non-surgical area infected site (OR1.53*109;95%CI0-), consecutive operation (OR3.57;95%CI0.627-20.340), not using nano silver antibacterial dressing (OR1.618;95%CI0.355-7.364), personnel management nonstandard during procedure(OR2.887;95%CI0.497-16.757), course of prophylactic antibacterial (OR7.704;95%CI0.692-61.690).2The SSI prediction system establishment for orthopaedic joint replacement surgeryThe prediction system establishment by7independent risk factors(each1point).The prediction system reveals good accuracy or good predictive power of the test to detect patients with SSI when compared with NNIS and SENIC system by the ROC curve.ConclusionThe indepandent risk factors for surgical site infection in orthopaedic joint replacement surgery can be concluded in7elements (ⅰ) age>65;(ⅱ) cancer;(ⅲ) preoperative non-surgical area infected site;(ⅳ) consecutive operation;(ⅰⅴ) not using nano silver antibacterial dressing;(ⅵ) personnel management nonstandard during procedure;(ⅶ) course of prophylactic antibacterial. The joint replacement surgery SSI prediction system established by the independent risk factors had a better function to detect patients with SSI when compared with NNIS and SENIC.