基于倾向评分匹配法评估脑卒中手术患者医院感染与静脉血栓相关性

Correlation between healthcare-associated infection and venous thrombosis in stroke patients undergoing surgery: based on propensity score matching

摘要:

目的 探讨脑卒中手术患者医院感染与静脉血栓之间的相关性，为临床医务人员采取针对性预防与控制措施提供科学依据。 方法 前瞻性收集某医院2016年1月—2018年12月所有脑卒中手术患者的临床资料，根据是否发生医院感染分为感染组和非感染组，将两组患者进行1∶1倾向评分匹配（PSM），分析脑卒中患者术后医院感染与静脉血栓之间的关系。 结果 共纳入816例脑卒中手术患者，发生医院感染213例，医院感染发生率为26.10%，通过PSM均衡混杂因素后，发现患者医院感染与静脉血栓之间具有相关性（P < 0.001），Pearson列联系数C为0.192。不同部位医院感染组间静脉血栓发生率比较，差异具有统计学意义（P=0.037）。 结论 通过PSM法均衡混杂因素后，脑卒中手术患者医院感染与静脉血栓之间存在正相关性，在患者不良预后上可能具有协同作用，因此，应加强患者术后监测，做到早发现、早诊断、早治疗，及早采取干预措施，以降低并发症的发生风险，改善患者预后。

Abstract:

Objective To explore the correlation between healthcare-associated infection (HAI) and venous thrombosis in stroke patients undergoing surgery, and provide scientific basis for health care workers to take targeted prevention and control measures. Methods Clinical data of all stroke patients in a hospital from January 2016 to December 2018 were prospectively collected, they were divided into infection group and non-infection group accor-ding to whether HAI occurred, two groups of patients were matched with 1:1 propensity score matching (PSM), relationship between post-operative HAI and venous thrombosis in stroke patients was analyzed. Results A total of 816 stroke patients were included in study, 213 cases (26.10%) of HAI occurred, after confounding factors were balanced by PSM, there was a correlation between HAI and venous thrombosis (P < 0.001), Pearson contingency coefficient C was 0.192. Incidence of venous thrombosis was different among different HAI sites (P=0.037). Conclusion After the confounding factors are balanced by PSM, there is a positive correlation between HAI and thrombosis in stroke patients undergoing surgery, and may have a synergistic effect on the adverse prognosis of patients, therefore, post-operative monitoring should be strengthened, early detection, early diagnosis, early treatment and early intervention measures should be taken to reduce the risk of complication occurrence and improve the prognosis of patients.