眼科手术后感染性眼内炎的影响因素及直接经济损失

Influencing factors and direct economic loss of infective endophthalmitis after ophthalmic operation

目的探讨眼科手术后感染性眼内炎发生的影响因素及其经济损失,为其预防控制措施的制定以及卫生经济学研究提供相关依据。方法选取2013年1月—2018年12月某院眼科手术后发生感染性眼内炎的患者作为病例组,采用病例对照研究方法,选择性别相同、年龄、入院时间相近的术后非感染患者作为对照组进行1∶3配比。对患者基础疾病及手术情况等因素进行单因素及多因素logistic回归分析,并比较病例组与对照组患者住院日数及各项住院费用。结果共调查眼科手术24867例,发生感染性眼内炎25例,发病率为0.10%。不同年份眼科手术后感染性眼内炎发病率比较,差异有统计学意义(P<0.05)。单因素分析结果显示,糖尿病、青光眼、眼外伤史、入住日间病房是眼科手术后发生感染性眼内炎的影响因素(均P<0.05);多因素logistic回归分析结果显示,糖尿病、眼外伤史、入住日间病房是眼科手术后感染性眼内炎的独立危险因素(均P<0.05)。病例组和对照组的中位住院日数分别为12、3 d,差异具有统计学意义(P<0.001)。病例组和对照组的总住院费用中位数分别为10477.97、8042.60元,差异具有统计学意义(P<0.05)。病例组的床位费、护理费、西药费均高于对照组,差异具有统计学意义(均P<0.05)。结论糖尿病、眼外伤、入住日间病房为感染性眼内炎发生的危险因素,眼内炎可导致患者住院时间延长,住院费用增加。

Objective To explore the influencing factors and economic loss of infective endophthalmitis after ophthalmic operation,provide relevant evidence for the formulation of prevention and control measures as well as study of health economics.Methods Patients with infective endophthalmitis after ophthalmic operation in a hospital between January 2013 and December 2018 were selected as case group,non-infective patients of the same gender,age and hospital admission time were selected as control group for 1∶3 case control study.Underlying diseases and operation status of patients were performed univariate and multivariate logistic regression analysis,length of hospital stay and various hospitalization expense were compared between case group and control group.Results A total of 24867 ophthalmic operations were investigated,25 cases of infective endophthalmitis occurred,with an incidence of 0.10%.Incidence of infective endophthalmitis after ophthalmic operation in different years was statistically significant(P<0.05).Univariate analysis showed that diabetes mellitus,glaucoma,history of ocular trauma and stay in day care ward were the influencing factors for infective endophthalmitis after ophthalmic operation(all P<0.05);multivariate logistic regression analysis showed that diabetes mellitus,history of ocular trauma and stay in day care ward were independent risk factors for infective endophthalmitis after ophthalmic operation(all P<0.05).The median length of hospital stay in case group and control group were 12 days and 3 days respectively,difference was statistically significant(P<0.001).The median of total hospitalization expense of case group and control group were 10477.97 and 8042.60 yuan respectively,difference was statistically significant(P<0.05).The bed fee,nursing fee and Western medicine fee of case group were all higher than those of control group,differences were all statistically significant(all P<0.05).Conclusion Diabetes mellitus,history of ocular trauma and stay in day care ward are the risk factors for infective endophthalmitis after ophthalmic operation,endophthalmitis can lead to prolongation of hospital stay and increase of hospitalization expense.