Fatores associados a infecção de sítio cirúrgico em neonatos: ênfase na hipotermia perioperatória

Abstract

Health care-related infections (HAI) are considered one of the most frequent adverse events related to health care and a serious public health problem, affecting more than 30% of neonates. Among the topographies of HAIs, Surgical Site Infection (SSI) is directly related to surgical procedures, being considered an HAI of great relevance. Some risk factors are considered predisposing to the occurrence of SSI in the neonate, among them hypothermia can be an important contributing factor to morbidity and mortality since it worsens or favors metabolic disorders, respiratory distress, necrotizing enterocolitis, intracranial hemorrhage, and site infection surgical. The present study aims to analyze the factors associated with SSI, with emphasis on perioperative hypothermia, in neonates at a public pediatric hospital in the Northeast region. This is an epidemiological, case-control, paired, retrospective study whose data source is the medical records of newborn patients from a hospital specializing in pediatrics in the State of Bahia from 2017 to 2020. Data were collected through of an instrument elaborated for this purpose and typed in a Microsoft Excel program bank, later exported to the R software for statistical analysis. Quantitative variables were analyzed using absolute and relative frequencies. For the analysis of the measures of association of the possible risk factors involved with the outcome variable (ISC), a bivariate analysis of the data was performed. The measurement of the strength of association was performed using the Odds Ratio (OR) and its 95% confidence interval (CI). It was possible to verify that the degree of moderate hypothermia presented after surgery was associated with SSI. Most patients were male, were classified as full-term in terms of their gestational age, normal birth weight, and had discharge as an outcome. The surgeries of the gastrointestinal system were the most frequent and the ones that presented the most clinical evolution of surgical site infection and hypothermia in the perioperative period of neonates. It is extremely important that the health team, especially nurses, recognize hypothermia and know how to act in order to control the occurrence of thermal instability and its repercussions for the morbidity and mortality of the neonate, as well as the factors that can lead to the occurrence of SSI in the newborn. neonate.