开放性手外伤术后感染危险因素及预测分析

Analysis of risk factors and predictive efficacy of infection after open hand trauma

目的探讨开放性手外伤术后感染危险因素并进一步分析相关因素风险预测临床效能。方法回顾性纳入2020年6月至2023年6月于本院行手术治疗开放性手外伤患者共106例,根据术后有无感染出现分组,比较感染组和无感染组临床特征资料,采用Logistics回归模型多因素分析评估开放性手外伤术后感染独立危险因素,描绘ROC曲线分析上述独立危险因素用于开放性手外伤术后感染风险预测临床效能。结果本研究纳入于本院行手术治疗开放性手外伤患者106例中出现术后感染11例,发生率为10.38%。单因素分析结果显示,年龄、吸烟、合并糖尿病、有无手术创面污染、受伤至手术时间、ASA评分、手术时间及是否行负压引流均可能与开放性手外伤术后感染发生有关(P<0.05)。Logistic回归模型多因素分析结果显示,年龄≥60岁、合并糖尿病、受伤至手术时间≥6 h、手术创面污染及未行负压引流均是开放性手外伤术后感染发生独立危险因素(P<0.05)。ROC曲线分析结果显示,年龄、是否合并糖尿病、受伤至手术时间、有无手术创面污染及有无行负压引流均可用于开放性手外伤术后感染发生风险预测,且上述指标联合预测效能显著优于单一指标(P<0.05)。结论开放性手外伤术后感染发生与年龄、是否合并糖尿病、受伤至手术时间、有无手术创面污染及有无行负压引流关系密切;而上述指标联合在预测开放性手外伤术后感染发生风险方面显示出更优临床效能。

Objective To investigate the risk factors and predictive efficacy of infection after open hand trauma.Methods 106 patients with open hand trauma surgery in our hospital from June 2020 to June 2023 were retrospectively included and divided into different groups according to with or without postoperative infection.The clinical characteristics of the infected group and the non-infected group were compared,and the independent risk factors of postoperative infection after open hand trauma were evaluated by multivariate analysis of Logistics regression model.ROC curves were drawn to analyze the clinical efficacy of these independent risk factors in predicting of infection risk after open hand trauma.Results There were 13 cases with postoperative infection in all 106 patients with open hand trauma underwent surgery in our hospital for incidence of 12.26%.Univariate analysis showed that age,smoking,diabetes mellitus,surgical wound contamination,time from injury to operation,ASA score,time of operation and whether negative pressure drainage was performed were all related to postoperative infection after open hand trauma(P<0.05).Multivariate analysis of Logistic regression model showed that age≥60 years,diabetes mellitus,time from injury to operation≥6 h,surgical wound contamination and no negative pressure drainage were all independent risk factors for postoperative infection after open hand trauma(P<0.05).ROC curve analysis results showed that age,whether diabetes was complicated,time from injury to surgery,whether surgical wound was contaminated and whether negative pressure drainage was performed could be used to predict the risk of postoperative infection after open hand trauma,and the combined prediction efficiency of the above indexes was significantly better than single index(P<0.05).Conclusion The incidence of postoperative infection after open hand trauma was closely related to age,diabetes,time from injury to operation,surgical wound contamination and negative pressure drainage and the combination of these indicators showed better clinical efficacy in predicting of infection after open hand trauma surgery risk.