Thickness of Subcutaneous Fat Is a Predictive Factor of Incisional Surgical Site Infection in Crohn's Disease Surgery: A Retrospective Study
Thickness of Subcutaneous Fat Is a Predictive Factor of Incisional Surgical Site Infection in Crohn's Disease Surgery: A Retrospective Study
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皮下脂肪厚度是克罗恩病手术中切口手术部位感染的预测因素：一项回顾性研究
DOI：
10.1155/2018/1546075
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发表时间：
2018-01-01
影响因子：
2
通讯作者：
Zhu, Weiming
中科院分区：
文献类型：
--
作者：
Cai, Xingchen;Shen, Weisong;Zhu, Weiming
切口手术部位感染（iSSI）是克罗恩病（CD）患者腹部手术的常见术后并发症。在这项研究中，我们调查了接受肠切除术的CD患者的皮下脂肪厚度（TSF）和iSSI之间的相关性。患者和方法本回顾性研究纳入了2014年1月至2017年1月接受腹部手术的CD患者。收集患者的TSF和其他可能的iSSI预测因子，包括临床特征、术前用药、血液学指标、手术相关数据和术后结局。单因素和多因素统计分析被用来检查潜在的因素。采用受试者工作特征（ROC）曲线分析各因素的预测价值。结果患者队列包括246例患者（167例男性（67.9%）;平均年龄35.7 ± 12.4岁;平均病程69.6 ± 60.8个月）。iSSI的发生率为24.8%（61/246）。TSF是iSSI的显著预测因子（OR 1.079，95% CI（1.020，1.142），P = 0.008），iSSI患者的TSF为13.7 mm，无iSSI患者的TSF为9.9 mm（P < 0.001）。此外，如单变量和多变量分析所示，C反应蛋白（CRP）浓度（OR 1.059，P = 0.003）也可能是iSSI的预测因子。包含TSF和CRP浓度的iSSI模型具有中等准确性（AUC 0.827，CI（0.766，0.888））。结论术前TSF和CRP是影响CD患者肠切除术后iSSI的独立因素。
Background Incisional surgical site infection (iSSI) is a frequent postoperative complication of abdominal surgeries in patients with Crohn's disease (CD). In this study, we investigated the association between thickness of subcutaneous fat (TSF) and iSSI in patients with CD undergoing intestinal resections. Patients and Methods Patients with CD who had undergone abdominal surgery from January 2014 to January 2017 were included in this retrospective study. Patients' TSF and other possible predictors of iSSI, including clinical characteristics, preoperative medications, hematological index, surgery-related data, and postoperative outcomes, were collected. Univariate and multivariate statistical analyses were used to examine the potential factors. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of factors. Results The patient cohort comprised 246 patients (167 male (67.9%); mean age 35.7 ± 12.4 years; mean disease duration 69.6 ± 60.8 months). The incidence of iSSI was 24.8% (61/246). TSF was a significant predictor of iSSI (OR 1.079, 95% CIs (1.020, 1.142), P = 0.008), being 13.7 mm in patients with iSSI and 9.9 mm in those without iSSI (P < 0.001). Additionally, C-reactive protein (CRP) concentrations (OR 1.059, P = 0.003) were also possible predictors of iSSI, as indicated by both univariate and multivariate analysis. A model of iSSI comprising TSF and CRP concentrations was moderately accurate (AUC 0.827, CIs (0.766, 0.888)). Conclusions Preoperative TSF and CRP independently affect iSSI in patients with CD undergoing intestinal resections.