Correlation Analysis Of Risk Factors For Infection After Hysterectomy

Objective:The clinical data of 282 patients who underwent total hysterectomy were collected to observe the postoperative infection of patients who underwent total hysterectomy,and to analyze the clinical risk factors related to postoperative infection,so as to formulate scientific and reasonable clinical prevention measures.Methods:The clinical data of 5401 patients who underwent hysterectomy in the Department of Gynecology of the Affiliated Hospital of Qingdao University from January 2018 to December2021 were selected and retrospectively analyzed.Data of 94 patients with infection after hysterectomy were collected.According to the principle of statistical control matching,two patients without infection after hysterectomy were randomly selected from each infected patient for matched control.The patients included in the study were divided into infection group(94 cases)and control group(188 cases).The basic data and surgical related indicators of the patients in the group were analyzed,such as: age,BMI(body mass index),underlying diseases,etiology of the operation(main diagnosis),uterine size,history of abdominal surgery,length of preoperative hospital stay,time of preoperative antibiotic application,preoperative bowel preparation,operation time,intraoperative blood loss,intraoperative adhesion,operation method,postoperative indwelling catheter time and postoperative indwelling drainage tube time,etc.Univariate analysis and Logistic regression analysis were used to analyze the risk factors of infection after hysterectomy.The ROC curve was used to calculate the optimal threshold of quantitative data in independent risk factors.Results:1.The results of univariate analysis showed that the patient’s age,BMI,underlying disease,main diagnosis(ovarian mass,conization,uterine fibroids,endometrial hyperplasia and adenomyosis),uterine size,history of abdominal surgery,length of preoperative hospital stay,time of preoperative antibiotic use,preoperative bowel preparation,history of preoperative reproductive system inflammation,preoperative vaginal manipulation,operation time,intraoperative adhesion and postoperative indwelling catheter time were compared.The influence of postoperative infection was significant(P<0.05).2.Multivariate Logistic regression analysis suggested that BMI,underlying diseases,main diagnosis,uterine size,preoperative hospital stay,preoperative bowel preparation,preoperative reproductive system inflammation history,preoperative vaginal operation,and postoperative indwelling catheter time were independent risk factors for postoperative infection(P<0.05).3.According to the results of ROC curve,the uterine size at 10 weeks gestation,BMI,preoperative hospitalization days and postoperative indwelling catheter time were positively correlated with the occurrence of postoperative infection.4.The most common bacterial infection after hysterectomy was Gram-negative bacteria(68.65%),followed by Gram-positive bacteria(31.35%),and no fungal infection was found.5.The incidence of drug resistance in pathogens infected after hysterectomy was 53.73%,and the most common drug-resistant bacteria in postoperative infection were bacteria producing extended-spectrum β-lactamases.Conclusions:1.In this study,it was found that BMI,underlying diseases,main diagnosis,uterine size,preoperative hospital stay,preoperative bowel preparation,preoperative reproductive system inflammation history,preoperative vaginal operation,and postoperative indwelling catheter time were independent risk factors for postoperative infection.Surgical methods(laparoscopy,laparotomy,and laparoscopic conversion to laparotomy)and preoperative bowel preparation are not risk factors for postoperative infection。2.According to the results of ROC curve,the uterine size at 10 weeks gestation,BMI,preoperative hospitalization stay and postoperative indwelling catheter time were positively correlated with the occurrence of postoperative infection.3.The common pathogenic bacteria of infection after hysterectomy in this group are Gram-negative bacteria,and Escherichia coli has the highest probability of drug-resistant bacteria.The most common drug-resistant bacteria type is bacteria that can produce extendedspectrum β-lactamases.