Risk factors for postoperative pulmonary infecton in severe craniocerebral injury patients undergoing early tracheotomy and establishment of nomogram model
OBJECTIVE To analyze the risk factors for postoperative pulmonary infecton in severe craniocerebral in-jury patients undergoing early tracheotomy and establishment of nomogram model.METHODS A total of 120 pa-tients with tracheotomy in the early stage of severe craniocerebral injury in our hospital from Mar 2020 to Mar 2023 were included in the study.According to the incidence of pulmonary infection,they were divided into the pul-monary infection group(42 cases)and the non-pulmonary infection group(78 cases).The clinical data and inter-leukin-6(IL-6)gene-572C/G polymorphism between the two groups were compared,and the susceptibility factors of pulmonary infection after early tracheotomy of severe craniocerebral injury were analyzed by logistic regression analysis,And the nomogram prediction model and logistic regression model were constructed to evaluate the pre-diction value in the occurrence of pulmonary infection after tracheotomy in the early stage of severe craniocerebral injury.RESULTS Pulmonary infection occurred in 42 cases(35.00％)of 120 patients with severe craniocerebral injury undergoing early tracheotomy.Compared with the non-pulmonary infection group,the proportion of GG genotype of IL-6 gene-572C/G polymorphic allele and the frequency of allele G were higher in the pulmonary infec-tion group(P＜0.05).The results of multivariate logistic analysis showed that hypoproteinemia,indindent gastric tube and genotype GG were the prerisk factors for pulmonary infection after tracheotomy in the early stage of se-vere craniotomy(P＜0.05).The four independent predictors selected by the above model were incorporated into the model to construct a nomogram prediction model for the risk of pulmonary infection after early tracheotomy with severe brain injury.The Hosmer-Lemeshow fitting test showed that a good accuracy of model fitting(X2=6.869,P=0.551).The calibration curve showed that the predicted probability is close to the actual probability,indicating good distinguishing,calibration and forecasting ability of this model.CONCLUSION The occurrence of pulmonary infection after early tracheotomy in severe craniocerebral injury is related to IL-6 gene-572 C/G poly-morphism,so a prediction model could be built and a basis for the formulation of preventive measures can be provided.
Severe craniocerebral injuryEarly stageTracheotomyPulmonary infectionRisk factorInterleu-kin-6Gene polymorphismPrediction model
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