Logistic Regression Analysis And Risk Estimation Of Intra- Abdominal Infections After Pancreaticouduodenectomy

Objective:Intra-abdominal infection(IAI)is one of the main complications after Pancreaticouduodenectomy(PD).With the ascension of the surgical technique and the rapid development of science and technology,although mortality and the incidence ofcomplications after PD declined obviously than decades ago,intra-abdominal infection after PD show a rising trend.Patients with intra-abdominal infection after PD not only prolong the length of hospital stay,increase the rates of readmission,and endanger the lives of patients.To provide a certain theoretical basis for the prevention and treatment of intra-abdominalinfection,this article analyzes 143 patients who underwent PD in our hospital from March2015 to May 2019,and explores the risk factors and incidence of IAI in patients after PD.Method:This article analyzes 143 patients who underwent PD in our hospital fromMarch 2015 to May 2019,and explores the risk factors and incidence of IAI in patients after PD.According to the"Expert Consensus on the Prevention and Treatment of CommonComplications after Pancreatic Surgery(2017)",the 143 patients were divided into theinfection infection group and the non-infection infection group.All clinical data,for example general conditions(such as age,gender,etc.),preoperative indicators(such as albumin,alanine transferase,etc.),and intraoperative indicators(Such as operation time,blood loss during operation,etc.),and postoperative conditions(extubation time,enteral nutrition time,etc.),were tested by~2 test or t test of SPSSS 25.0.Then the statistically significant(P<0.05)risk factors were analyzed by Logistic regression test and independent risk factors were screened out.A risk prediction model for patients with intra-abdominal infection after PD was established.Then the test efficiency of the model is evaluated by the ROC curve.Descriptive studies were performed on categorical variables such as bacterial types and drug resistance.The data obtained from multiple repeated measurements at different points-in-time were analyzed by applying single factor analysis of variance.Independent sample t-tests were used to compare and analyze the mean between groups of indicators at the same time.Data obtained from multiple repeated measurements at the same points-in-time were analyzed by applying independent sample t-test.Result:Of the 143 patients,52 were assigned to the infected group and 91 patients non-infected group.The intra-abdominal infection rate,in this study,was 36.36%.It wes showed by single factor analysis that preoperative jaundice,preoperative infection,whether jaundice time is more than 1 month,abnormal BMI,whether preoperative Alb level is more than 30g/L,whether biliary drainage is performed before operation,whether blood transfusion ismore than 800ml,whether intraoperative bleeding is more than 500ml,whether operation time is more than 5 hours,pancreatic leakage after operation,whether the drainage tube is carried for more than 10 days,whether the Alb level is is less than 30 g/L on the fourth day after surgery,and whether the enteral nutrition time is more than 4 days were statistically significant.It wes showed by multivariate analysis that jaundice time is more than 1 month,blood transfusion is more than 800ml,intraoperative bleeding is more than 500ml,operation time is more than 5 hours,pancreatic leakage after operation,the drainage tube is carried for more than 10 days,the Alb level is is less than 30 g/L on the fourth day after surgery,and the enteral nutrition time is more than 4 days were independent risk factors for intra-abdominal infection after PD.Conclusion:Postoperative abdominal infections are related to the following factors,such as jaundice time,pre-and postoperative hypoalbuminemia,massive blood transfusions,more blood loss during the operation,long operation time,pancreatic leakage,length of the abdominal drainage tube and enteral nutrition starts later.In the clinic,in order to reduce the incidence of abdominal infection after PD,the following measures should be taken,such as the nutritional status of the patient should be assessed in a timely manner,enteral nutrition should be fed early,surgery skills and techniques should be improved,the indications for blood transfusion should be strictly controlled,and"ineffective"long-term placement of abdominal drainage tubes should be avoided.