Avaliação dos fatores de risco para infecção do sitio cirúrgico de pacientes submetidos à neurocirurgia

Abstract

Surgical infections are important for their morbidity, mortality and as a health care quality marker. The surgical site infection (SSI) is ranked second in incidence in the hospital and means that the microorganism has beaten the host s defenses. This epidemiological, descriptive, retrospective study was based on medical charts and aimed at evaluating risk factors for surgical site infection in patients submitted to neurological surgery in a hospital of the south of Minas Gerais, Brazil. It verified the association of variables, such as antibiotic therapy, use of drains and antiseptics, with surgical site infection. Two-hundred and seventy-eight patients were investigated. Inclusion criteria: (1) subjects having been operated upon at the above-mentioned hospital, with or without SSI, either during hospitalization or as long as 30 (thirty) after dismissal, according to the Ministry of Health, Portaria no. 2616; (2) patients who were not submitted to surgery at another institution. The survey was done from January 2006 to January 2008 after having been approved by the Unifenas Committee of Ethics in Research. Data were analyzed with the help of software SPSS version 10. The chi-square test with 5% significance level was used for crossing variables. The data were statistically significant for p<0.05. The data were found in the sample: 74.5% of males; 25.5% of females; 57.2% were married; 31.7% had undergone emergency surgery; 36.3%, LHD (lumbar herniated disc) surgery; 2.9% had surgery time of 510 minutes; 37.1% were classified ASA I for host susceptibility; 20.1% were ASA II; 100% used antibiotics and vesical probe; 90.6% received general anesthesia; 65.8% were skin shaved; 42.4% used drains. Regarding post-operative signs and symptoms, 16.9% had only fever. There was a statistically significant association between the variable fever with the variables antibiotics , drain and antiseptic . The identification of variables for the control of important risk factors would be relevant (such as drainage of purulent exsudate from the incision, associated with heat, redness, local abscesses, etc.). This would make possible the correlation of rates generated by such variables with probable risk factors, as, for example, the surgical risk index (SRI). This study showed the need for educative measures related to the recording of notes about the care given to the patients aiming at quality and humanization of health assistance.