Analysis of factors influencing postoperative abdominal infection in critically ill patients with trauma
10.3760/cma.j.cn115396-20240518-00152
- VernacularTitle:关于外伤急危重症患者术后腹腔感染影响因素的分析
- Author:
Qi ZHANG
1
;
Huadong WU
;
Weiying DING
Author Information
1. 首都医科大学石景山教学医院 北京市石景山医院重症医学科，北京 100040
- Keywords:
Emergencies;
Abdominal cavity;
Infection;
Risk factors;
Acute and severe trauma
- From:
International Journal of Surgery
2024;51(8):548-553
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influencing factors of postoperative abdominal infection in critically ill patients with trauma.Methods:A retrospective case-control analysis was conducted on the clinical data of 82 patients who underwent critical surgery in Beijing Shijingshan Hospital from July 2020 to September 2023. There were 52 males and 30 females. Age ranged from 19 to 63 years old, with an average age of (44.50±14.55) years. According to whether the patient has developed infection after surgery, they were divided into an infected group ( n=20) and an uninfected group ( n=62). To compare the differences between the two groups intraoperative data (bleeding volume, cholangioenterostomy, crystal infusion volume, colloid infusion volume, laparoscopic use, operation time and surgical incision length) and postoperative data (ascites, anastomotic leakage, preventive stoma, pulmonary infection). Normally distributed measurement data were expressed as mean±standard deviation ( ± s), and independent samples t-test was used for comparison between groups; Chi-square test was used for comparison between groups for count data. Single factor analysis and multivariate Logistic regression were used to analyze the risk factors for postoperative abdominal infection in critically ill patients with trauma. Results:The number of cases of biliary intestinal anastomosis, bleeding volume, crystal infusion volume, and colloid infusion volume in the infected group were 12 cases, (573.26±206.21) mL, (4 531.0±258.0) mL, and (1 612.0±96.0) mL, respectively. The uninfected group was 14 cases, (468.25±174.21) mL, (2 753.0±226.0) mL, and (1 105.0±85.0) mL, respectively. The difference between the two groups was statistically significant ( P<0.05). The incidence rates of postoperative ascites, anastomotic fistula, prophylactic stoma, and postoperative pulmonary infection in the infected group were 25.00%, 65.00%, 25.00%, and 55.00%, respectively, while those in the non infected group were 9.68%, 27.42%, 51.61%, and 24.19%, respectively. The difference between the two groups was statistically significant ( P<0.05). Multivariate logistic regression analysis showed that postoperative ascites, biliary intestinal anastomosis, postoperative anastomotic fistula, and postoperative pulmonary infection ( OR=5.504, 4.432, 18.172, 7.687, 95% CI: 1.456-20.754, 1.175-16.669, 4.752-69.418, 2.141-27.595, P<0.05) were risk factors for the risk of postoperative abdominal infection. Conclusion:The risk factors for postoperative abdominal infection in critically ill patients with trauma include postoperative ascites, biliary intestinal anastomosis, postoperative anastomotic fistula, and postoperative pulmonary infection. Special attention needs to be paid to postoperative monitoring and treatment.
