Distribution of pathogens isolated from hepatocellular carcinoma resection patients with postoperative abdominal infection,risk factors and establishment of prediction model
OBJECTIVE To observe the distribution of pathogens,analyze the risk factors for postoperative abdomi-nal infection in the hepatocellular carcinoma resection patients,establish the risk prediction model,and analyze its predictive efficiency.METHODS The clinical data were retrospectively collected from 466 patients who underwent hepatocellular carcinoma resection in Xixi Hospital in Hangzhou City from Jan 2020 to Mar 2023.The enrolled pa-tients were divided into the infection group with 56 cases and the no infection group with 410 cases according to the status of postoperative abdominal infection.The distribution of pathogens was statistically analyzed,univariate a-nalysis and multivariate analysis were performed for the risk factors for the postoperative abdominal infection,the risk prediction model was established,and the predictive value of the model was analyzed.RESULTS A total of 65 strains of pathogens were isolated from the 56 hepatocellular carcinoma resection patients with postoperative ab-dominal infection,60.00％of which were gram-negative bacteria,35.38％were gram-positive bacteria,and 4.62％were fungi.The risk factors for the postoperative abdominal infection in the hepatocellular carcinoma re-section patients included the no less than 60 years of age,complication with diabetes mellitus,operation duration no less than 300 min,abdominal drainage tube indwelling time no less than 7 days and serum albumin less than 35 g/L(OR=2.181,2.793,2.582,3.882,2.355,P＜0.05).The area under curve(AUC)of the risk prediction model that was established based on the risk factors was 0.749 in diagnosis of the postoperative abdominal infec-tion in the hepatocellular carcinoma resection patients,with the sensitivity 70.00％,the specificity 87.56％.CONCLUSION Escherichia coli,Pseudomonas aeruginosa and Staphylococcus aureus are the predominant species of pathogens isolated from the hepatocellular carcinoma resection patients with postoperative abdominal infection.The risk factors include the no less than 60 years of age,complication with diabetes mellitus,operation duration no less than 300 min,abdominal drainage tube indwelling no less than 7 days and serum albumin level less than 35 g/L.The risk prediction model shows favorable diagnostic value.
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