Risk factors for postoperative biliary tract infection in ERCP patients and establishment of prediction model
OBJECTIVE To explore the distribution of pathogens and risk factors for postoperative biliary tract in-fection in the patients undergoing endoscopic retrograde cholangiopancreatography(ERCP)and establish the pre-diction model.METHODS Totally 1 040 patients who underwent ERCP in the First Affiliated Hospital of Air Force Military Medical University from Oct 2020 to Oct 2022 were recruited as the research subjects and were di-vided into the biliary tract infection group with 30 cases and the no biliary tract infection group with 1 010 cases according to the status of postoperative biliary tract infection.The clinical data were collected from the patients,the distribution of pathogens and risk factors for the biliary tract infection were analyzed,the prediction model was established,and the predictive value of the model was analyzed by receiver operating characteristic(ROC)curves.RESULTS Among the 1 010 patients who underwent ERCP,30 had postoperative biliary tract infection,with the incidence rate 2.88％.Totally 42 strains of pathogens were isolated,among which Escherichia coli was domi-nant,followed by Enterococcus faecalis.Location of biliary tract obstruction,no prophylactic use of antibiotics af-ter ERCP and complication with diabetes mellitus were the independent risk factors for the postoperative biliary tract infection(P＜0.05).The prediction model was as follows:Logit(P)=-11.087+high location of biliary tract obstruction× 0.927+no prophylactic use of antibiotics after ERCP× 0.958+complication with diabetes mellitus × 1.042,the ROC curves for the prediction of postoperative biliary tract infection were drawn according to the diagnostic probability Logit(P),when the Logit(P)was greater than 11,the AUC was 0.843,with the sensi-tivity 86.67％,the specificity 67.43％.CONCLUSION The gram-negative bacteria are dominant among the patho-gens isolated from the ERCP patients with postoperative biliary tract infection.The risk factors include the high location of biliary tract obstruction,no prophylactic use of antibiotics after ERCP and complication with diabetes mellitus.The prediction model has high predictive value.
Endoscopic retrograde cholangiopancreatographyBiliary tract infectionPathogenRisk factorPre-diction model
NETL
NSTL
万方数据
维普
