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Vojnosanitetski pregled
2020, vol. 77, br. 5, str. 525-531
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 15/06/2020
doi: 10.2298/VSP180521125T
Creative Commons License 4.0
Incidenca, bolnička smrtnost i faktori rizika za nastanak bolnički stečene pneumonije kod bolesnika nakon intraabdominalnih hirurških procedura, hospitalizovanih u bolnici tercijernog nivoa zdravstvene zaštite u Beogradu, Srbija - case-control studija
aVojnomedicinska akademija, Klinika za pulmologiju, Beograd
bVojnomedicinska akademija, Klinika za opštu hirurgiju, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
cVojnomedicinska akademija, Klinika za opštu hirurgiju, Beograd
dUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
eUniverzitet u Beogradu, Medicinski fakultet, Institut za epidemiologiju
fUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Klinika za urgentnu internu medicinu, Beograd
gUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Odsek za prevenciju i kontrolu bolničkih infekcija, Beograd

e-adresa: tausandjordje@gmail.com

Sažetak

Uvod/Cilj. Bolnički stečena pneumonija u populaciji hirurških bolesnika značajno povećava obolevanje i smrtnost, produžava vreme bolničkog lečenja i povećava troškove lečenja. Cilj rada je bio da se odrede incidenca, bolnička smrtnost i faktori rizika (FR) za nastanak bolnički stečene pneumonije kod bolesnika podvrgnutih intrabdominalnim hirurškim procedurama, bolnički lečenim u ustanovi tercijernog nivoa zdravstvene zaštite u Beogradu, Srbija. Metode. Kroz uobičajeni bolnički nadzor hirurških bolesnika nakon intraabdominalnih hirurških procedura, prospektivno smo identifikovali postoperativno nastale bolnički stečene pneumonije u periodu od pet godina. U "mečovanoj" slučaj-kontrola studiji, svaki hirurški bolesnik sa bolnički stečenom pneumonijom je poređen sa četiri kontrolna ispitanika (bez bolnički stečene pneumonije). U grupi bolesnika sa bolnički stečenom pneumonijom, umrli su poređeni sa preživelim bolesnicima. Rezultati. Od svih bolesnika, 1,4% je razvilo bolnički stečenu pneumoniju u postoperativnom periodu nakon intraabdominalne hirurške procedure. Incidenca bolnički stečene pneumonije (na 1000 operativnih procedura) bila je najveća kod bolesnika koji su bili podvrgnuti eksplorativnoj laparotomiji (102,6), potom hirurgiju tankog creva (36,6) i hirurgiji želuca (22,7). Multivarijantnom logističkom regresionom analizom (MLRA) identifikovana su tri nezavisna FR udružena sa bolnički stečenom pneumonijom: multiple transfuzije [p = 0,011; odds ratio (OR): 4,26; 95% confidence interval (CI): 1,59-11,33), dužina bolničkog lečenja (p = 0,024; or: 1,02; 95% CI: 1,00-1,03) i lečenje u jedinici intenzivne nege (p = 0,043; or: 2,83; 95% CI: 1,03-7,71)]. MLRA je identifikovala samo infekciju hirurškog mesta kao nezavisni FR povezan sa lošijim ishodom bolnički stečene pneumonije (p = 0,017; or: 5,929; CI 95%: 1,37-25,67). Zaključak. Rezultati studije su značajni u potvrđivanju odnosa između FR i bolnički stečene pneumonije kod bolesnika podvrgnutih intraabdominalnim hirurškim procedurama.

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