骨盆骨折急诊术后感染的危险因素、病原菌特点及诊断指标分析OACSTPCD

Objective To analyze the risk factors,pathogenic bacteria characteristics and diagnostic in-dexes of infection after emergency operation of pelvic fracture.Methods A total of 393 patients with pelvic fracture emergency operation admitted and treated in this hospital from November 2019 to December 2022 were selected as the study subjects.Twenty-eight patients with postoperative infection served as the infection group,and 365 patients without infection as the non-infection group.The clinical characteristics were com-pared between the two groups and the procalcitonin(PCT),neutrophil/leucocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)levels in peripheral blood of the patients were detected.The multivariate logistic re-gression was used to analyze the influencing factors.The receiver operating characteristic(ROC)curve was a-dopted to evaluated the diagnostic efficiency of PCT,NLR and PLR for infection after pelvic fracture emergen-cy operation.Results Among 393 cases of pelvic fracture emergency operation,infection occurred in 28 cases,with an incidence rate of 7.12％(28/393).The results of multivariate logistic regression analysis showed that BMI(OR=2.049),ISS(OR=2.439),operation time(OR=2.369),intraoperative blood loss volume(OR=2.781),complicating brain trauma(OR=2.248),complicating abdominal injury(OR=3.469),complicating acetabular fracture(OR=3.109)and complicating diabetes mellitus(OR=3.519)were the influencing fac-tors of infection after pelvic fracture emergency operation(P＜0.05).Among 28 cases of infection,30 strains of pathogenic bacteria were cultured.Escherichia coli,Staphylococcus aureus and Pseudomonas aeruginosa were the common pathogenic bacteria of infection.The levels of peripheral blood NLR,PLR and PCT in the infection group were higher than those in the non-infection group(P＜0.05).The areas under the curves(AUC)of peripheral blood NLR,PLR and PCT in diagnosing infection after pelvic fracture emergency opera-tion were 0.814,0.798 and 0.856 respectively.AUC of PLR+NLR,PCT+NLR and PCT+PLR were 0.877,0.903 and 0.857 respectively,and the diagnostic efficiency of the three combination was the highest(0.917).Conclusion The influencing factors of infection after pelvic fracture emergency operation are BMI,ISS,opera-tion time,intraoperative blood loss volume,complicating brain trauma,complicating abdominal injury,compli-cating acetabulum fracture and complicating diabetes mellitus.Escherichia coli,Staphylococcus aureus and pseudomonas aeruginosa are common pathogenic bacteria of infection.The combined detection of NLR,PLR and PCT could be used to the diagnosis of infection after pelvic fracture emergency operation.