摘要
OBJECTIVE:To identify risk factors for febrile morbidity after hysterectomy for nonmalignan t indications.METH-ODS:We performed a retrospective co hort study of 686women who had a hysterectomy between January and September 1997by abdominal(n =408),laparoscopic -assisted vaginal(n =90),or vaginal(n =188)ap-proaches.Potential risk factors fo r febrile morbidity were extracted from the medical records.By means of multi-variable logistic regression,we evaluated demographic,reproductive,clinical,and operative risk factors for febrile morbidity.RESULTS:The risk of postoperative febrile morbidity in this population was 14%.Only 50%of women received prophylactic antibi otics,whereas almost20%received no antibiotics at all,a nd 30%were ad-ministered antibiotics after surgical incision.Risk factors for febrile morbidity after hystere ctomy,after controlling forage,body mass index,operative time ,and prophylactic antibiotic administration,were ab dominal approach(odds ratio 2.7;95%confidence interval 1.6,4.3)and blood loss at surgery of more than 750mL(odds ratio 3.5;95%confidence interval 1.8,6.8).CONCLUSION:Hys-terectomy by abdominal approach and increased blood loss at the time of surgery significantly increase the risk of febrile morbidity.Preventive effo rts should focus on meth-ods to reduce postoperative febrile morbidity,including meticulous surgical technique and r outine use and appro-priate timing of prophylactic antib iotic therapy.
OBJECTIVE:To identify risk factors for febrile morbidity after hysterectomy for nonmalignan t indications.METH-ODS:We performed a retrospective co hort study of 686women who had a hysterectomy between January and September 1997by abdominal(n =408),laparoscopic -assisted vaginal(n =90),or vaginal(n =188)ap-proaches.Potential risk factors fo r febrile morbidity were extracted from the medical records.By means of multi-variable logistic regression,we evaluated demographic,reproductive,clinical,and operative risk factors for febrile morbidity.RESULTS:The risk of postoperative febrile morbidity in this population was 14%.Only 50%of women received prophylactic antibi otics,whereas almost20%received no antibiotics at all,a nd 30%were ad-ministered antibiotics after surgical incision.Risk factors for febrile morbidity after hystere ctomy,after controlling forage,body mass index,operative time ,and prophylactic antibiotic administration,were ab dominal approach(odds ratio 2.7;95%confidence interval 1.6,4.3)and blood loss at surgery of more than 750mL(odds ratio 3.5;95%confidence interval 1.8,6.8).CONCLUSION:Hys-terectomy by abdominal approach and increased blood loss at the time of surgery significantly increase the risk of febrile morbidity.Preventive effo rts should focus on meth-ods to reduce postoperative febrile morbidity,including meticulous surgical technique and r outine use and appro-priate timing of prophylactic antib iotic therapy.
