Influencing factors for postoperative puerperal infection in cesarean section patients and establishment of prediction model
OBJECTIVE To explore the distribution of pathogens isolated from the cesarean section patients with postoperative puerperal infection and analyze the influencing factors.METHODS A total of 658 patients who under-went cesarean section in Meishan People's Hospital from Jan 2022 to Dec 2022 were recruited as the research sub-jects and were divided into the infection group with 33 cases and the non-infection group with 625 cases according to the status of postoperative puerperal infection.The clinical data were compered between the two groups,logistic analysis was performed for the influencing factors for the postoperative puerperal infection in the cesarean section patients,the prediction model for infection was established,and the predictive efficiency of the model was ana-lyzed.RESULTS The incidence of postoperative puerperal infection was 5.02％among the cesarean section pa-tients.Gram-negative bacteria were dominant among the pathogens isolated from the patients with infection.The result of logistic regression analysis showed that postpartum hemorrhage,prenatal genital tract infection and pre-mature rupture of membrane were the influencing factors for the postoperative puerperal infection in the cesarean section patients(OR=7.078,8.071,8.338,P＜0.05).The established risk model for postoperative puerperal in-fection was as follows:Logit(P)=-4.068+postpartum hemorrhage× 1.957+prenatal genital tract infection× 2.088+premature rupture of membrane×2.121.Receiver operating characteristic(ROC)curves for the postoper-ative puerperal infection were drawn based on diagnostic probability Logit(P),when Logit(P)was more than 0.1,the area under curve(AUC)was 0.794,and 95％CI was 0.709-0.878.The sensitivity of the model was 81.80％for diagnosis,with the specificity 72.40％.CONCLUSION The incidence of postoperative puerperal infec-tion is high among the cesarean section patients.The patients with gram-negative bacteria infection are dominant.Postpartum hemorrhage,prenatal genital tract infection and premature rupture of membrane are the influencing factors for the postoperative puerperal infection in the cesarean section patients.
Cesarean sectionPuerperal infectionPathogenInfluencing factorNomogramPrediction model
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