Fatores de risco para infecção de sítio cirúrgico em procedimentos gerais em um hospital público de Belo Horizonte, Minas Gerais: um estudo de incidência

Abstract

This is a historical cohort study from the data of 17.707 patients who underwent any surgical procedure in a teaching hospital in Belo Horizonte, Minas Gerais, between the years of 2008 and 2011. This study had as main objective to analyze the epidemiological aspects of the Surgical Site Infection (SSI) in the patients who underwent general surgical procedures. As secondary objectives it aim to assess the global SSI incidence; to estimate the SSI incidence in different types of surgical procedures; to identify the risk factors for SSI in the collected variables; to identify the main microorganisms responsible for the SSI; and to compare the prediction power of NISS risk index compared with the model built with this study database. To achieve the proposed objectives the data was analyzed descriptively and it was build a logistic regression model to verify the association of the study variables with the SSI. It was found a global incidence of 3,32% [CI 95% = 3,06 3,59]. The procedures that had the greatest SSI incidence was Peripheral vascular bypass surgery, 14,52% [CI 95% = 9,79 20,41]; Spleen surgery, 14,29% [CI 95% = 1,77 42,81]; and gallbladder surgeries, 13,86% [CI 95% = 8,99 20,06]. The risk factors related with the SSI in the logistic regression model was preoperative hospital time longer than 24 hours, surgical length, Wound Class, ASA index and postoperative hospital time longer than 2 days. The Staphyloccocus aureus was the most prevalent bacteria isolated from the patients diagnosed with SSI (47 out of 177), being followed by Escherichia coli. The data found in this study is similar to those in international papers, except in this study preoperative hospital time longer than 24 hours and postoperative hospital time longer than 2 days were also a risk factor. Another difference was the SSI incidence rate, it was greater than the incidence found in researchs with the American population. This indicates that great efforts are necessary to reduce the SSI rates in surgical populations similar to this study and more studies are needed to better comprehend the risk factors for SSI in this population.