Objective To evaluate the prognostic outcomes of pulmonary infection after congenital heart disease(CHD)in children,and to explore and analyze the related factors of poor prognosis.Methods One hundred and seventy-three children with postoperative lung infection after CHD admitted to the Department of Paediatric Cardiothoracic Surgery of the First Affiliated Hospital of Xinjiang Medical University from January 2022 to December 2023 were taken as the study subjects,and they were divided into 61 cases of the poor prognosis group and 112 cases of the good prognosis group ac-cording to the prognosis at 28 d of admission.Multifactorial logistic regression was used to analyse the influencing factors of poor prognosis in children with postoperative CHD lung infection;R software was used to construct a column chart pre-diction model of poor prognosis in children with postoperative CHD lung infection;subject work characteristics(ROC)curves were used to assess the discriminatory degree of poor prognosis predicted by the column chart model in children with postoperative CHD lung infection,and calibration curves were used to assess the model's consistency.Results In the poor prognosis group,the proportion of children with immunodeficiency,mechanical ventilation time ≥48 h,New York Heart Association(NYHA)cardiac function class Ⅲ-Ⅳ,left ventricular ejection fraction(LVEF)≤40％,WBC＞12 × 109/L,NEU＞70％,procalcitonin(PCT)＞05 μg/L,and albumin(Alb)≤35 g/L were all greater than those in the good prognosis group(x2/P=7.273/＜0.001,15.949/＜0.001,9.414/0.002,10.473/0.001,29.572/＜0.001,21.811/＜0.001,10.154/0.001,11.864/0.001);multifactorial logistic regression analysis showed that immunodeficiency,mechanical ventilation time ≥48 h,NYHA cardiac function class Ⅲ-Ⅳ,LVEF ≤40％,WBC＞12 × 109/L,NEU＞70％,Alb ≤35 g/L,and PCT＞05 μg/L were the inde-pendent risk factors for poor prognosis in children with postoperative lung infection after CHD[OR(95％CI)=7.381(2.513-21.677),5 295(1.801-15.568),8.928(3.030-26.300),5.563(1.962-15.774),3.108(1.590-6.076),2.058(1.429-2.963),3.415(1211-9.626),5 269(1.799-15.429)],and constructed a column-line graphical model;the validation results showed that the area under the ROC curve(AUC)was 0.969(95％CI0.945-0.992),and the model predicted the risk of poor prognosis for children with postoperative lung infection after CHD in good agreement with the actual risk(x=7.086,P=0.681).Conclu-sion Immunity,duration of mechanical ventilation,NYHA cardiac function class,LVEF,WBC,NEU,ALB,PCT are the in-dependent risk factors affecting the occurrence of poor prognosis in children with postoperative lung infection after CHD,and the column chart model constructed in this way has a good degree of differentiation and consistency,which is more in-tuitive for predicting the risk of its occurrence,and effective measures should be taken according to these factors,and ac-tive intervention should be carried out to reduce the risk of poor prognosis.
万方数据
维普
