腹腔镜阑尾切除术后腹腔内脓肿的独立预测因素--低预后营养指数水平

IF 1.1 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-12-01 DOI:10.1097/SLE.0000000000001328

Yijian Yuan, Yanhua Tang, Yubin Liu, Pengcheng Ren

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引用次数: 0

摘要

背景：腹腔内脓肿（IAA）是腹腔镜阑尾切除术后一种非常常见的术后并发症，与不良预后有关：本研究回顾性分析了2015年至2024年接受腹腔镜阑尾切除术的老年患者，研究了人口统计学、临床和实验室数据，以确定IAA的风险因素。通过多变量逻辑回归分析，筛选并最终确定了IAA的独立风险因素：共有37名患者在术后30天内出现IAA，发生率为9.6%（37/385）。接收者操作特征曲线（ROC）分析表明，白细胞（截断值：13.35，敏感性：54.60%，特异性：70.27%，P=0.003）和预后营养指数（PNI）（截断值：41.95，敏感性：72.00%，P=0.003）与术后 30 天内发生 IAA 的患者数量相关：41.95，敏感性：72.41%，特异性：59.46%，P=0.003：穿孔性阑尾炎老年患者的 PNI 评分

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A Low Prognostic Nutritional Index Level, an Independent Predictor for Postoperative Intra-abdominal Abscess After Laparoscopic Appendectomy.

Background: Intra-abdominal abscess (IAA) is a very common postoperative complication after laparoscopic appendectomy and is associated with poor prognosis.

Materials and methods: This study retrospectively analyzed elderly patients who underwent laparoscopic appendectomy from 2015 to 2024, examining demographic, clinical, and laboratory data to identify IAA risk factors. Independent risk factors for IAA were screened and finally identified by multivariate logistic regression analysis.

Results: A total of 37 patients developed IAA within postoperative 30 days, with an incidence of 9.6% (37/385). Receiver operating characteristic (ROC) curve analysis indicated white blood cell (cut-off value: 13.35, sensitivity: 54.60%, specificity: 70.27%, P =0.003) and Prognostic Nutritional Index (PNI) (cut-off value: 41.95, sensitivity: 72.41%, specificity: 59.46%, P <0.0001) were 2 predictors for IAA with an area under the curve of 0.649 and 0.727, respectively. Based on the multivariate analysis, perforated appendicitis (odds ratio: 2.48, 95% CI: 1.15-5.32, P =0.021) and a lower PNI score (odds ratio: 3.44, 95% CI: 1.49-7.58, P =0.002) were 2 independent risk factors for IAA in elderly patients after laparoscopic appendectomy.

Conclusions: Elderly patients with perforated appendicitis and a PNI score <41.95 have higher risks for IAA after laparoscopic appendectomy.

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.