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Risk Factors to Predict Post-Operative Organ/Space Infection After Appendectomy in the Pediatric Population: A Retrospective Case Control Analysis

机译:预测儿童阑尾切除术后器官/间隙感染的危险因素:回顾性病例对照分析

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Background: Post-operative organ/space infection (OSI) is associated with prolonged hospital stay or re-admission. Here, we explore the predictors for OSI in pediatric patients after appendectomy.Patients and Methods: Among post-appendectomy pateints, the OSI was reviewed. A multicenter case control study was conducted to explore the risk factors for OSI among pediatric patients with appendicitis after appendectomy between January 2009 and December 2019. The potential risk factors associated with OSI were explored using multivariable logistic regression methods.Results: In the current cohort, 723 patients fulfilled the OSI criteria. According to multivariable logistic regression analysis, the occurrence of OSI was associated with complicated appendicitis (odds ratio OR, 1.82; 95 confidence interval CI, 1.03-3.686; p = 0.016), the lower the level of pre-operative lymphocyte-C-reactive protein (LCR; OR, 14.42; 95 CI, 1.57-73.26; p < 0.001), pan-peritonitis (OR, 4.36; 95 CI, 1.34-21.66; p = 0.006), systemic inflammatory response syndrome (SIRS; OR, 8.22; 95 CI, 1.84-49.63; p < 0.001), and abscess presentation (OR, 11.32; 95 CI, 2.03-61.86; p < 0.001). The receiver operating characteristic (ROC) curve evaluation further confirmed the relatively high accuracy of the above factors to predict OSI.Conclusions: The identified potential risk factors in the current research can be used for OSI identification in patients after appendectomy. Recognition of the risk factors may allow the choice of the treatment process more reasonably.
机译:背景:术后器官/间隙感染 (OSI) 与住院时间延长或再入院有关。在这里,我们探讨了阑尾切除术后儿科患者 OSI 的预测因素。患者和方法:在阑尾切除术后的患者中,对 OSI 进行了评价。2009年1月至2019年12月,为探讨阑尾切除术后患儿阑尾炎患者OSI的危险因素,开展了一项多中心病例对照研究。采用多变量logistic回归方法探讨与OSI相关的潜在危险因素。结果:在当前队列中,723 例患者符合 OSI 标准。根据多因素logistic回归分析,OSI的发生与复杂性阑尾炎相关(比值比[OR],1.82;95%置信区间[CI],1.03-3.686;p=0.016),术前淋巴细胞C反应蛋白(LCR;或者,14.42;95% CI,1.57-73.26;p < 0.001)、泛腹膜炎(OR,4.36;95% CI,1.34-21.66;p = 0.006)、全身炎症反应综合征(SIRS;或者,8.22;95% CI,1.84-49.63;p < 0.001)和脓肿表现(OR,11.32;95% CI,2.03-61.86;p < 0.001)。受试者工作特征(ROC)曲线评估进一步证实了上述因素预测OSI的准确率相对较高。结论:本研究中发现的潜在危险因素可用于阑尾切除术后患者的OSI识别。识别危险因素可以更合理地选择治疗过程。

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