Multidrug-resistant tuberculosis.
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Biomedical subjects
Publications and source records attributed to N Galai.
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A multicenter study of 2846 consecutive hernia operations was conducted to identify risk factors for infections that occurred during the hospitalization and post-discharge from hospital. Operated patients were followed-up for 30 days after surgery, whether at home or still hospitalized, and half the wound infection episodes were found to occur at home. Risk factors for both in-hospital and post-discharge infections seemed to be influenced by; (a) the selective nature of discharge, (b) the differential effect some risk factors had on either early or late infections. On any given day, patients selected by the clinical team to remain in hospital were more "at risk" for infection than those who left. As a result, they had a better chance of being diagnosed as infected during hospitalization. By contrast, those who were discharged home were perceived as low risk for complications. Subsequent infections in these patients occurred either due to factors "causing" late infections, therefore, unappreciated at the time of discharge, or unknown risk factors. More study risk factors were associated with in-hospital than with post-discharge infections, especially those associated with "early" infections. The implications of these findings for future evaluations of medical care in hospitalized patients are discussed.
In a prospective follow-up of 2846 patients who underwent hernia repair in 22 general surgery departments in Israel, factors affecting early or late infections were explored. Risk factors included inherent patient characteristics such as old age, ethnic group, and type of hernia prior to the surgery. Patient management factors included duration of the operation, use of urinary catheters, and use of drains. Of the 12 variables studied, only three had a constant effect during the entire 30-day follow-up. The other factors affected the occurrence of either early or late infections, but not both. For example, patients undergoing long operations, or from ethnic minorities, had a high rate of early infection, while those with special wound treatment (such as evacuation of hematomas) had high rates of late infection. It is postulated that factors present at the time of the operative incision tend to "cause" early infections, while factors that accumulate over time, or develop after leaving the operating theater, tend to affect late infections.