Risk factors for postoperative pulmonary infections after cardiopulmonary bypass and their prediction model
OBJECTIVE To analyze the risk factors for postoperative pulmonary infections after cardiopulmonary bypass and their early warning model.METHODS Retrospective analysis was performed on 172 patients who com-pleted cardiac surgery with extracorporeal circulation in the ICU of a tertiary hospital from Jan.2021 to Dec.2022,and the patients were divided into an infection group(n=41)and a control group(n=131)according to postoper-ative pulmonary infection.Multivariate logistic regression was used to analyze and summarize the risk factors for postoperative pulmonary infection after cardiopulmonary bypass(CPB),to construct a multi-factor early warning model that applied in a combined manner,and to summarize the pathogenic bacteria of patients in the infected group.RESULTS Diabetes mellitus,duration of cardiopulmonary bypass,and American society of Anesthesiolo-gists(ASA)classification were risk factors for the occurrence of pulmonary infections in patients after cardiopul-monary bypass,and lymphocyte(LYM)was a protective factor(P＜0.05).The Log(P)early warning model constructed from risk factors had a high efficacy of early warning for the occurrence of pulmonary infections in pa-tients after cardiopulmonary bypass(CPB),and the area under the network subject operating characteristic curve(ROC-AUC)(0.95CI)was 0.884(0.769-0.969).In the infection group,gram-negative bacteria(70.59％)were the main pathogenic bacteria,and with Acinetobacter baumannrii(36.76％)as the main strain.CONCLUSION Diabetes mellitus,duration of cardiopulmonary bypass,and ASA grade Ⅲ-Ⅳ were risk factors for pulmonary infection after cardiopulmonary bypass,and LYM was a protective factor.Clinical monitoring and early warning should be strengthened for high-risk patients,and antibiotics should be given according to the strains of infection in time to improve the prognosis of patients.
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