Preoperative and operation-related risk factors for postoperative nosocomial infections in pediatric patients: A retrospective cohort study
Pediatric patients undergoing invasive operations bear extra risk of developing nosocomial infections (NIs). However, epidemiological evidence of the underlying risk factors, which is needed for early prevention, remains limited. Using data from the electronic medical records and the NI reporting sy...
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| Veröffentlicht in: | PloS one 2019-12, Vol.14 (12), p.e0225607-e0225607 |
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| creator | Li, Kuanrong Li, Xiaojun Si, Wenyue Cui, Yanqin Xia, Huimin Sun, Xin Song, Xingrong Liang, Huiying |
| description | Pediatric patients undergoing invasive operations bear extra risk of developing nosocomial infections (NIs). However, epidemiological evidence of the underlying risk factors, which is needed for early prevention, remains limited.
Using data from the electronic medical records and the NI reporting system of a tertiary pediatric hospital, we conducted a retrospective analysis to identify preoperative and operation-related risk factors for postoperative NIs. Multivariable accelerated failure time models were fitted to select independent risk factors. The performance of these factors in risk stratification was examined by comparing the empirical risks between the model-defined low- and high-risk groups.
A total of 18,314 children undergoing invasive operations were included for analysis. After a follow-up period of 154,700 patient-days, 847 postoperative NIs were diagnosed. The highest postoperative NI rate was observed for operations on hemic and lymphatic system. Surgical site infections were the NI type showing the highest overall risk; however, patients were more likely to develop urinary tract infections in the first postoperative week. Older age, higher weight-for-height z-score, longer preoperative ICU stay, preoperative enteral nutrition, same-day antibiotic prophylaxis, and higher hemoglobin level were associated with delayed occurrence of postoperative NIs, while longer preoperative hospitalization, longer operative duration, and higher American Society of Anesthesiologists score showed acceleration effects. Risk stratification based on these factors in an independent patient population was moderate, resulting in a high-risk group in which 72% of the postoperative NIs were included.
Our findings suggest that pediatric patients undergoing invasive operations and at high risk of developing postoperative NIs are likely to be identified using basic preoperative and operation-related risk factors, which together might lead to moderately accurate risk stratification but still provide valuable information to guide early and judicious prevention. |
| doi_str_mv | 10.1371/journal.pone.0225607 |
| format | Article |
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Using data from the electronic medical records and the NI reporting system of a tertiary pediatric hospital, we conducted a retrospective analysis to identify preoperative and operation-related risk factors for postoperative NIs. Multivariable accelerated failure time models were fitted to select independent risk factors. The performance of these factors in risk stratification was examined by comparing the empirical risks between the model-defined low- and high-risk groups.
A total of 18,314 children undergoing invasive operations were included for analysis. After a follow-up period of 154,700 patient-days, 847 postoperative NIs were diagnosed. The highest postoperative NI rate was observed for operations on hemic and lymphatic system. Surgical site infections were the NI type showing the highest overall risk; however, patients were more likely to develop urinary tract infections in the first postoperative week. Older age, higher weight-for-height z-score, longer preoperative ICU stay, preoperative enteral nutrition, same-day antibiotic prophylaxis, and higher hemoglobin level were associated with delayed occurrence of postoperative NIs, while longer preoperative hospitalization, longer operative duration, and higher American Society of Anesthesiologists score showed acceleration effects. Risk stratification based on these factors in an independent patient population was moderate, resulting in a high-risk group in which 72% of the postoperative NIs were included.
Our findings suggest that pediatric patients undergoing invasive operations and at high risk of developing postoperative NIs are likely to be identified using basic preoperative and operation-related risk factors, which together might lead to moderately accurate risk stratification but still provide valuable information to guide early and judicious prevention.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0225607</identifier><identifier>PMID: 31869341</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acceleration ; Age ; Antibiotics ; Blood tests ; Child health ; Child, Preschool ; Children's hospitals ; China - epidemiology ; Cohort analysis ; Cross Infection - epidemiology ; Cross Infection - etiology ; Development and progression ; Disease susceptibility ; Electronic health records ; Electronic medical records ; Electronic records ; Empirical analysis ; Enteral nutrition ; Epidemiology ; Failure times ; Female ; Follow-Up Studies ; Glycosylated hemoglobin ; Health aspects ; Health risks ; Hemoglobin ; Hemoglobins ; Hospital patients ; Hospitals ; Hospitals, Pediatric - statistics & numerical data ; Humans ; Infant ; Infection ; Infections ; Intensive care ; Lymphatic system ; Male ; Medical electronics ; Medical records ; Medical research ; Medical societies ; Medicine and Health Sciences ; Models, Biological ; Nosocomial infection ; Nosocomial infections ; Nutrition ; Parenteral nutrition ; Patients ; Pediatrics ; Preoperative Period ; Prevention ; Professional associations ; Prophylaxis ; Retrospective Studies ; Risk analysis ; Risk Assessment - methods ; Risk Factors ; Risk groups ; Studies ; Surgery ; Surgical Procedures, Operative - adverse effects ; Surgical site infections ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - etiology ; Tertiary Care Centers - statistics & numerical data ; Urinary tract ; Urinary tract infections ; Urinary Tract Infections - epidemiology ; Urinary Tract Infections - etiology</subject><ispartof>PloS one, 2019-12, Vol.14 (12), p.e0225607-e0225607</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Li et al 2019 Li et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-33bc388caa1bdcd9287ba43f2ce14cddf8f29ea03f82f8a6faf52cae0071fec63</citedby><cites>FETCH-LOGICAL-c692t-33bc388caa1bdcd9287ba43f2ce14cddf8f29ea03f82f8a6faf52cae0071fec63</cites><orcidid>0000-0001-5636-7969</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927644/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927644/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31869341$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Rynda-Apple, Agnieszka</contributor><creatorcontrib>Li, Kuanrong</creatorcontrib><creatorcontrib>Li, Xiaojun</creatorcontrib><creatorcontrib>Si, Wenyue</creatorcontrib><creatorcontrib>Cui, Yanqin</creatorcontrib><creatorcontrib>Xia, Huimin</creatorcontrib><creatorcontrib>Sun, Xin</creatorcontrib><creatorcontrib>Song, Xingrong</creatorcontrib><creatorcontrib>Liang, Huiying</creatorcontrib><title>Preoperative and operation-related risk factors for postoperative nosocomial infections in pediatric patients: A retrospective cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Pediatric patients undergoing invasive operations bear extra risk of developing nosocomial infections (NIs). However, epidemiological evidence of the underlying risk factors, which is needed for early prevention, remains limited.
Using data from the electronic medical records and the NI reporting system of a tertiary pediatric hospital, we conducted a retrospective analysis to identify preoperative and operation-related risk factors for postoperative NIs. Multivariable accelerated failure time models were fitted to select independent risk factors. The performance of these factors in risk stratification was examined by comparing the empirical risks between the model-defined low- and high-risk groups.
A total of 18,314 children undergoing invasive operations were included for analysis. After a follow-up period of 154,700 patient-days, 847 postoperative NIs were diagnosed. The highest postoperative NI rate was observed for operations on hemic and lymphatic system. Surgical site infections were the NI type showing the highest overall risk; however, patients were more likely to develop urinary tract infections in the first postoperative week. Older age, higher weight-for-height z-score, longer preoperative ICU stay, preoperative enteral nutrition, same-day antibiotic prophylaxis, and higher hemoglobin level were associated with delayed occurrence of postoperative NIs, while longer preoperative hospitalization, longer operative duration, and higher American Society of Anesthesiologists score showed acceleration effects. Risk stratification based on these factors in an independent patient population was moderate, resulting in a high-risk group in which 72% of the postoperative NIs were included.
Our findings suggest that pediatric patients undergoing invasive operations and at high risk of developing postoperative NIs are likely to be identified using basic preoperative and operation-related risk factors, which together might lead to moderately accurate risk stratification but still provide valuable information to guide early and judicious prevention.</description><subject>Acceleration</subject><subject>Age</subject><subject>Antibiotics</subject><subject>Blood tests</subject><subject>Child health</subject><subject>Child, Preschool</subject><subject>Children's hospitals</subject><subject>China - epidemiology</subject><subject>Cohort analysis</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - etiology</subject><subject>Development and progression</subject><subject>Disease susceptibility</subject><subject>Electronic health records</subject><subject>Electronic medical records</subject><subject>Electronic records</subject><subject>Empirical analysis</subject><subject>Enteral nutrition</subject><subject>Epidemiology</subject><subject>Failure times</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glycosylated hemoglobin</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Hemoglobin</subject><subject>Hemoglobins</subject><subject>Hospital patients</subject><subject>Hospitals</subject><subject>Hospitals, Pediatric - statistics & numerical data</subject><subject>Humans</subject><subject>Infant</subject><subject>Infection</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical electronics</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medical societies</subject><subject>Medicine and Health Sciences</subject><subject>Models, Biological</subject><subject>Nosocomial infection</subject><subject>Nosocomial infections</subject><subject>Nutrition</subject><subject>Parenteral nutrition</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Preoperative Period</subject><subject>Prevention</subject><subject>Professional associations</subject><subject>Prophylaxis</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Studies</subject><subject>Surgery</subject><subject>Surgical Procedures, Operative - adverse effects</subject><subject>Surgical site infections</subject><subject>Surgical Wound Infection - epidemiology</subject><subject>Surgical Wound Infection - etiology</subject><subject>Tertiary Care Centers - statistics & numerical data</subject><subject>Urinary tract</subject><subject>Urinary tract infections</subject><subject>Urinary Tract Infections - epidemiology</subject><subject>Urinary Tract Infections - etiology</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk8tu1DAUhiMEoqXwBggsISFYzOBL4jgskEYVl5EqFXHbWo5zPOMhE6e2U9Fn4KVxOmmZQV2gLOI43__b57dPlj0leE5YSd5s3OA71c5718EcU1pwXN7LjknF6IxTzO7vjY-yRyFsMC6Y4PxhdsSI4BXLyXH2-7MH14NX0V4CUl2Dpi_XzTy0KkKDvA0_kVE6Oh-QcR71LsS_os4Fp93WqhbZzoAetSENUQ-NVdFbjfpEQhfDW7RAHqJ3oR-5JNZu7XxEIQ7N1ePsgVFtgCfT-yT7_uH9t9NPs7Pzj8vTxdlM84rGGWO1ZkJopUjd6KaioqxVzgzVQHLdNEYYWoHCzAhqhOJGmYJqBRiXJG2Ps5Ps-c63b12QU45BUsZSQmWRk0Qsd0Tj1Eb23m6Vv5JOWXk94fxKKh-tbkHWuDGk0iWlrMqLklRc0LqEAgQrWFno5PVuWm2ot9DolINX7YHp4Z_OruXKXcpUbMnzPBm8mgy8uxggRLm1QUPbqg7csNs3SyHwIqEv_kHvrm6iVioVkM7MpXX1aCoXHFeFELgYU5rfQaWnga3V6dIZm-YPBK8PBImJ8Cuu1BCCXH798v_s-Y9D9uUeuwbVxnVw7XB9zw7BfAfqdMGCB3MbMsFy7JmbNOTYM3LqmSR7tn9At6KbJmF_AK0JFd4</recordid><startdate>20191223</startdate><enddate>20191223</enddate><creator>Li, Kuanrong</creator><creator>Li, Xiaojun</creator><creator>Si, Wenyue</creator><creator>Cui, Yanqin</creator><creator>Xia, Huimin</creator><creator>Sun, Xin</creator><creator>Song, Xingrong</creator><creator>Liang, Huiying</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-5636-7969</orcidid></search><sort><creationdate>20191223</creationdate><title>Preoperative and operation-related risk factors for postoperative nosocomial infections in pediatric patients: A retrospective cohort study</title><author>Li, Kuanrong ; Li, Xiaojun ; Si, Wenyue ; Cui, Yanqin ; Xia, Huimin ; Sun, Xin ; Song, Xingrong ; Liang, Huiying</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-33bc388caa1bdcd9287ba43f2ce14cddf8f29ea03f82f8a6faf52cae0071fec63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acceleration</topic><topic>Age</topic><topic>Antibiotics</topic><topic>Blood tests</topic><topic>Child health</topic><topic>Child, Preschool</topic><topic>Children's hospitals</topic><topic>China - epidemiology</topic><topic>Cohort analysis</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - etiology</topic><topic>Development and progression</topic><topic>Disease susceptibility</topic><topic>Electronic health records</topic><topic>Electronic medical records</topic><topic>Electronic records</topic><topic>Empirical analysis</topic><topic>Enteral nutrition</topic><topic>Epidemiology</topic><topic>Failure times</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glycosylated hemoglobin</topic><topic>Health aspects</topic><topic>Health risks</topic><topic>Hemoglobin</topic><topic>Hemoglobins</topic><topic>Hospital patients</topic><topic>Hospitals</topic><topic>Hospitals, Pediatric - statistics & numerical data</topic><topic>Humans</topic><topic>Infant</topic><topic>Infection</topic><topic>Infections</topic><topic>Intensive care</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical electronics</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medical societies</topic><topic>Medicine and Health Sciences</topic><topic>Models, Biological</topic><topic>Nosocomial infection</topic><topic>Nosocomial infections</topic><topic>Nutrition</topic><topic>Parenteral nutrition</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Preoperative Period</topic><topic>Prevention</topic><topic>Professional associations</topic><topic>Prophylaxis</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Risk groups</topic><topic>Studies</topic><topic>Surgery</topic><topic>Surgical Procedures, Operative - adverse effects</topic><topic>Surgical site infections</topic><topic>Surgical Wound Infection - epidemiology</topic><topic>Surgical Wound Infection - etiology</topic><topic>Tertiary Care Centers - statistics & numerical data</topic><topic>Urinary tract</topic><topic>Urinary tract infections</topic><topic>Urinary Tract Infections - epidemiology</topic><topic>Urinary Tract Infections - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Kuanrong</creatorcontrib><creatorcontrib>Li, Xiaojun</creatorcontrib><creatorcontrib>Si, Wenyue</creatorcontrib><creatorcontrib>Cui, Yanqin</creatorcontrib><creatorcontrib>Xia, Huimin</creatorcontrib><creatorcontrib>Sun, Xin</creatorcontrib><creatorcontrib>Song, Xingrong</creatorcontrib><creatorcontrib>Liang, Huiying</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Kuanrong</au><au>Li, Xiaojun</au><au>Si, Wenyue</au><au>Cui, Yanqin</au><au>Xia, Huimin</au><au>Sun, Xin</au><au>Song, Xingrong</au><au>Liang, Huiying</au><au>Rynda-Apple, Agnieszka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative and operation-related risk factors for postoperative nosocomial infections in pediatric patients: A retrospective cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-12-23</date><risdate>2019</risdate><volume>14</volume><issue>12</issue><spage>e0225607</spage><epage>e0225607</epage><pages>e0225607-e0225607</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Pediatric patients undergoing invasive operations bear extra risk of developing nosocomial infections (NIs). However, epidemiological evidence of the underlying risk factors, which is needed for early prevention, remains limited.
Using data from the electronic medical records and the NI reporting system of a tertiary pediatric hospital, we conducted a retrospective analysis to identify preoperative and operation-related risk factors for postoperative NIs. Multivariable accelerated failure time models were fitted to select independent risk factors. The performance of these factors in risk stratification was examined by comparing the empirical risks between the model-defined low- and high-risk groups.
A total of 18,314 children undergoing invasive operations were included for analysis. After a follow-up period of 154,700 patient-days, 847 postoperative NIs were diagnosed. The highest postoperative NI rate was observed for operations on hemic and lymphatic system. Surgical site infections were the NI type showing the highest overall risk; however, patients were more likely to develop urinary tract infections in the first postoperative week. Older age, higher weight-for-height z-score, longer preoperative ICU stay, preoperative enteral nutrition, same-day antibiotic prophylaxis, and higher hemoglobin level were associated with delayed occurrence of postoperative NIs, while longer preoperative hospitalization, longer operative duration, and higher American Society of Anesthesiologists score showed acceleration effects. Risk stratification based on these factors in an independent patient population was moderate, resulting in a high-risk group in which 72% of the postoperative NIs were included.
Our findings suggest that pediatric patients undergoing invasive operations and at high risk of developing postoperative NIs are likely to be identified using basic preoperative and operation-related risk factors, which together might lead to moderately accurate risk stratification but still provide valuable information to guide early and judicious prevention.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31869341</pmid><doi>10.1371/journal.pone.0225607</doi><tpages>e0225607</tpages><orcidid>https://orcid.org/0000-0001-5636-7969</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-12, Vol.14 (12), p.e0225607-e0225607 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2330057541 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acceleration Age Antibiotics Blood tests Child health Child, Preschool Children's hospitals China - epidemiology Cohort analysis Cross Infection - epidemiology Cross Infection - etiology Development and progression Disease susceptibility Electronic health records Electronic medical records Electronic records Empirical analysis Enteral nutrition Epidemiology Failure times Female Follow-Up Studies Glycosylated hemoglobin Health aspects Health risks Hemoglobin Hemoglobins Hospital patients Hospitals Hospitals, Pediatric - statistics & numerical data Humans Infant Infection Infections Intensive care Lymphatic system Male Medical electronics Medical records Medical research Medical societies Medicine and Health Sciences Models, Biological Nosocomial infection Nosocomial infections Nutrition Parenteral nutrition Patients Pediatrics Preoperative Period Prevention Professional associations Prophylaxis Retrospective Studies Risk analysis Risk Assessment - methods Risk Factors Risk groups Studies Surgery Surgical Procedures, Operative - adverse effects Surgical site infections Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology Tertiary Care Centers - statistics & numerical data Urinary tract Urinary tract infections Urinary Tract Infections - epidemiology Urinary Tract Infections - etiology |
| title | Preoperative and operation-related risk factors for postoperative nosocomial infections in pediatric patients: A retrospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-30T09%3A23%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Preoperative%20and%20operation-related%20risk%20factors%20for%20postoperative%20nosocomial%20infections%20in%20pediatric%20patients:%20A%20retrospective%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Li,%20Kuanrong&rft.date=2019-12-23&rft.volume=14&rft.issue=12&rft.spage=e0225607&rft.epage=e0225607&rft.pages=e0225607-e0225607&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0225607&rft_dat=%3Cgale_plos_%3EA609588056%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2330057541&rft_id=info:pmid/31869341&rft_galeid=A609588056&rft_doaj_id=oai_doaj_org_article_b0df19c7223945719682b7e5e835375c&rfr_iscdi=true |