胃癌术后腹腔感染危险因素及其预测模型构建  

Risk factors for postoperative abdominal infection in gastric cancer patients and establishment of prediction model

作　　者：孙玉[1] 李思源[2] 党晓青[3] 姜玲[4] 王培鑫 SUN Yu;LI Si-yuan;DANG Xiao-qing;JIANG Ling;WANG Pei-xin(Qingdao Municipal Hospital,Qingdao,Shandong 266000,China;不详)

机构地区：[1]青岛市市立医院病案管理科,山东青岛266000 [2]青岛市市立医院普外科,山东青岛266000 [3]青岛市市立医院变态反应科,山东青岛266000 [4]青岛市市立医院血液净化中心,山东青岛266000

出　　处：《中华医院感染学杂志》2024年第1期59-62,共4页Chinese Journal of Nosocomiology

基　　金：山东省科研基金资助项目(2021HG02111)。

摘　　要：目的分析胃癌术后腹腔感染的危险因素,并构建感染预测模型,为临床预防术后感染提供参考依据。方法选取2018年9月-2022年12月青岛市市立医院收治的胃癌手术患者481例纳入研究,根据术后腹腔感染发生情况分为感染组43例和非感染组438例,回顾性收集患者临床资料,单因素及多因素Logistic分析胃癌术后腹腔感染的危险因素并构建预测模型,受试者工作特征(ROC)曲线分析模型对胃癌术后腹腔感染的预测价值。结果多因素Logistic分析结果显示:肿瘤大小≥4 cm、手术时间≥240 min、低蛋白血症、淋巴血管侵犯为胃癌术后腹腔感染的危险因素(P<0.05);将上述因素纳入预测模型:Logit(P)=-11.432+0.608×肿瘤大小≥4 cm+0.811×手术时间≥240 min+0.678×低蛋白血症+0.655×淋巴血管侵犯,将胃癌术后腹腔感染纳入阳性,无术后腹腔感染纳入阴性,绘制ROC曲线,结果显示,当Logit(P)>12.60时,曲线下面积(AUC)为0.883,诊断敏感度为88.37%、特异性为82.42%。结论胃癌术后腹腔感染危险因素较多,构建预测模型对胃癌术后腹腔感染具有良好的预测价值,可筛选高危人群,进而进行有效干预。OBJECTIVE To analyze the risk factors for postoperative abdominal infection in the gastric cancer pa-tients and establish the prediction model so as to provide basis for clinical prevention of postoperative infection.METHODS Totally 481 gastric cancer patients who underwent surgical procedures in Qingdao Municipal Hospital from Sep 2018 to Dec 2022 were enrolled in the study and were divided into the infection group with 43 cases and the non-infection group with 438 cases according to the status of postoperative abdominal infection.The clinical data were retrospectively collected from the patients.Univariate analysis and multivariate logistic regression analy-sis were performed for the risk factors for the postoperative abdominal infection,the prediction model was estab-lished.The value of the model in prediction of the postoperative abdominal infection was analyzed by receiver op-erating characteristic(ROC)curves.RESULTS The result of multivariate logistic analysis showed that tumor size no less than 4 cm,operation duration no less than 240 min,hypoproteinemia and lymphovascular invasion were the risk factors for the postoperative abdominal infection in the gastric cancer patients(P<0.05).The prediction model was established based on the above factors:Logit(P)=-11.432+0.608×tumor size≥4 cm+0.811×operation duration no less than 240 min+0.678×hypoproteinemia+0.655×lymphovascular invasion;the pa-tients with postoperative abdominal infection were marked as positive,and the patients without postoperative ab-dominal infection were marked as negative,ROC curves were drawn;when Logit(P)was greater than 12.60,the area under curve(AUC)was 0.883,with the sensitivity 88.37%,the specificity 82.42%.CONCLUSION There are a variety of risk factors for the postoperative abdominal infection in the gastric cancer patients.The prediction model has favorable value in prediction of the postoperative abdominal infection,it can screen out the high-risk population,and the effective intervention measures can be carried out.

关 键 词：胃癌 腹腔感染 危险因素 模型 预测价值 

分 类 号：R735[医药卫生—肿瘤]