Obesity in regional anesthesia - a risk factor for peripheral catheter-related infections

被引：23

作者：

Bomberg, H. ^{[1
]}

Albert, N. ^{[1
]}

Schmitt, K. ^{[1
]}

Graeber, S. ^{[2
]}

Kessler, P. ^{[3
]}

Steinfeldt, T. ^{[4
]}

Hering, W. ^{[5
]}

Gottschalk, A. ^{[6
]}

Standl, T. ^{[7
]}

Stork, J. ^{[8
]}

Meissner, W. ^{[9
]}

Tessmann, R. ^{[10
]}

Geiger, P. ^{[11
,12
]}

Koch, T. ^{[13
]}

Spies, C. D. ^{[14
,15
]}

Volk, T. ^{[1
]}

Kubulus, C. ^{[1
]}

机构：

[1] Univ Saarland, Med Ctr, Dept Anesthesiol Intens Care Med & Pain Med, Homburg, Germany

[2] Univ Saarland, Med Ctr, Inst Epidemiol, Dept Biostat & Med Informat, Homburg, Germany

[3] Orthoped Univ Hosp, Dept Anesthesiol Intens Care & Pain Med, Frankfurt, Germany

[4] Univ Marburg, Dept Anesthesiol & Intens Care Therapy, Marburg, Germany

[5] St Marien Krankenhaus Siegen, Dept Anesthesiol, Siegen, Germany

[6] Friederikenstift Hannover, Dept Anesthesiol Intens Care & Pain Med, Hannover, Germany

[7] Acad Hosp Solingen, Dept Anesthesia Intens & Palliat Care Med, Solingen, Germany

[8] Univ Med Ctr Hamburg Eppendorf, Dept Anesthesiol, Ctr Anesthesiol & Intens Care Med, Hamburg, Germany

[9] Friedrich Schiller Univ Hosp, Dept Anesthesiol & Intens Care, Jena, Germany

[10] Berufsgenossenschaftl Unfallklin, Dept Anesthesiol Intens Care & Pain Therapy, Frankfurt, Germany

[11] Univ Ulm, Dept Anesthesiol Intens Care & Pain Therapy, D-89069 Ulm, Germany

[12] Rehabil Clin, Ulm, Germany

[13] Tech Univ Dresden, Carl Gustav Carus Univ Hosp, Dept Anesthesiol Intens Care & Pain Therapy, D-01062 Dresden, Germany

[14] Charitr Campus Virchow Klinikum, Dept Anesthesiol & Operat Intens Care Med, D-13353 Berlin, Germany

[15] Charite, D-13353 Berlin, Germany

来源：

ACTA ANAESTHESIOLOGICA SCANDINAVICA | 2015年 / 59卷 / 08期

关键词：

COMPLICATIONS; SURGERY; MANAGEMENT; ANALGESIA; BLOCK;

D O I：

10.1111/aas.12548

中图分类号：

R614 [麻醉学];

学科分类号：

100217 [麻醉学];

摘要：

BackgroundObesity is believed to increase the risk of surgical site infections and possibly increase the risk of catheter-related infections in regional anesthesia. We, therefore, analyzed the influence of obesity on catheter-related infections defined within a national registry for regional anesthesia. MethodsThe German Network for Regional Anesthesia database with 25 participating clinical centers was analyzed between 2007 and 2012. Exactly, 28,249 cases (13,239 peripheral nerve and 15,010 neuraxial blocks) of patients 14years were grouped in I: underweight (BMI 13.2-18.49kg/m(2), n=597), II: normal weight (BMI 18.5-24.9kg/m(2), n=9272), III: overweight (BMI 25.0-29.9kg/m(2), n=10,632), and IV: obese (BMI 30.0-70.3kg/m(2), n=7,744). The analysis focused on peripheral and neuraxial catheter-related infections. Differences between the groups were tested with non-parametric ANOVA and chi-square (P<0.05). Binary logistic regression was used to compare obese, overweight, or underweight patients with normal weight patients. Odds ratios (OR and 95% confidence interval) were calculated and adjusted for potential confounders. ResultsConfounders with significant influence on the risk for catheter-related infections were gender, age, ASA score, diabetes, preoperative infection, multiple skin puncture, and prolonged catheter use. The incidence (normal weight: 2.1%, obese: 3.6%; P<0.001) and the risk of peripheral catheter-related infection was increased in obese compared to normal weight patients [adjusted OR: 1.69 (1.25-2.28); P<0.001]. In neuraxial sites, the incidence of catheter-related infections differed significantly between normal weight and obese patients (normal weight: 3.2%, obese: 2.3%; P=0.01), whereas the risk was comparable [adjusted OR: 0.95 (0.71-1.28); P=0.92]. ConclusionThis retrospective cohort study suggests that obesity is an independent risk factor for peripheral, but not neuraxial, catheter-related infections.

引用

页码：1038 / 1048

页数：11

共 36 条

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The comparative effects of postoperative analgesic therapies on pulmonary outcome: Cumulative meta-analyses of randomized, controlled trials [J].