Risk factors for nosocomial infection after cardiac surgery and their association with the TGF-β1/Smads signaling pathway
OBJECTIVE To investigate the risk factors for postoperative nosocomial infection after cardiac surgery and their association with transforming growth factor beta 1(TGF-β1)/Smads signaling pathway.METHODS The clinical data of 573 patients undergoing cardiac surgery admitted to Sichuan Academy of Medical Sciences/Sichuan People's Hospital/University of Electronic Science and Technology of China from Mar.2022 to Mar.2023 were retrospectively analyzed,and they were divided into infected group(85 cases)and non-infected group(488 cases)according to nosocomial infection.The risk factors of postoperative nosocomial infection in patients with cardiac surgery were summarized.The expression levels of TGF-β1,Smad2 and Smad3 were detected.The expression lev-els of TGF-β1,Smad2 and Smad3 were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of TGF-β1,Smad2 and Smad3 alone and in combination for postoperative nosocomial infection in patients undergoing cardiac surgery.RESULTS The risk factors of postopera-tive nosocomial infection were operation time,diabetes mellitus,coadministration of antibiotics,second operation and length of hospitalization days(OR=1.912,1.984,2.356,1.996,2.128,all P＜0.05).The expression levels of TGF-β1,Smad2 and Smad3 in the infected group were higher than those in the non-infected group(P＜0.05).The area under the curve(AUC)of TGF-β1,Smad2,Smad3 alone and combined detection for the diagnosis of postoperative nosocomial infection in patients with cardiac surgery were 0.757,0.765,0.731,and 0.858,respec-tively.The AUC of combined diagnosis was higher than that of single detection(P＜0.05),and the sensitivity and specificity of combined detection were 67.10％and 88.00％,respectively.CONCLUSION The TGF-β1/Smads sig-naling pathway was activated in patients with nosocomial infection after cardiac surgery.The combined detection of TGF-β1,Smad2 and Smad3 was helpful in the diagnosis of postoperative nosocomial infection in patients undergo-ing cardiac surgery.Clinical treatment and intervention measures could be tailored according to risk factors to re-duce the risk of postoperative nosocomial infection in cardiac surgery patients.
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