保健医学研究与实践2025，Vol.22Issue(1)：67-73,7.DOI:10.11986/j.issn.1673-873X.2025.01.11
腰椎后路术后切口早期感染的危险因素分析及CAR的预测价值
Analysis of risk factors for early postoperative incisional infection after posterior lumbar surgery and the predictive value of CAR
摘要
Abstract
Objective To investigate the risk factors for early postoperative incisional infection after posterior lumbar surgery and the predictive value of the C-reactive protein(CRP)-to-albumin ratio(CAR),providing a reference for infection preven-tion.Methods A total of 756 patients who underwent posterior lumbar decompression with pedicle screw fixation at Guang-dong Armed Police Corps Hospital from December 2018 to December 2023 were enrolled.Among them,27 patients with in-cisional infections within 30 postoperative days were assigned to the infection group,while the remaining 729 patients com-prised the non-infection group.Clinical data were collected,and multivariate logistic stepwise regression was used to identify risk factors.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of CRP,albumin(ALB),and CAR for early infection.Results The incidence of early infection was 3.57%(27/756).Univariate analysis showed significant differences(P<0.05)in the infection group for:time of operation≥3 h,≥3 surgical segments,intrao-perative blood loss≥1 000 mL,interrupted suturing,drainage duration>5 days,and hypertension prevalence.No differ-ences were observed in sex,age,preoperative white blood cell count,lymphocyte count,hemoglobin levels,combined dia-betes,smoking history,or alcohol history(P>0.05).The infection group had higher CRP and CAR and lower ALB levels compared with the non-infection group(P<0.05).The AUCs(95%CI)for CRP,ALB,and CAR were 0.841(95%CI:0.796-0.886),0.719(95%CI:0.674-0.769),and 0.940(95%CI:0.895-0.985),respectively,with CAR demon-strating superior predictive value.Logistic stepwise regression analysis identified preoperative ALB<35.95 g/L(OR=2.026,95%CI:1.246-3.294),time of operation≥3 h(OR=1.732,95%CI:1.258-2.383),blood loss≥1 000 mL(OR=1.929,95%CI:1.281-2.906),and CAR≥0.70(OR=3.615,95%CI:1.953-6.689)as independent risk fac-tors(P<0.05).Conclusion Early incisional infection is strongly associated with elevated preoperative CAR.Additional risk factors include ALB<35.95 g/L,prolonged time of operation(≥3 h),and significant blood loss(≥1 000 mL).Pa-tients should be closely monitored for preoperative CAR and serum ALB levels clinically to achieve preoperative risk stratifi-cation management and reduce the risk of early postoperative incision infection.关键词
腰椎后路手术/术后感染/C反应蛋白/白蛋白比值/危险因素/预测效能Key words
Posterior lumbar surgery/Postoperative infection/CRP-to-albumin ratio/Risk factors/Predictive efficacy分类
临床医学引用本文复制引用
王华仁,陈杰,姚楚亮,杨焱鑫,廖臻,杜杰明,钟永聪,曾辉..腰椎后路术后切口早期感染的危险因素分析及CAR的预测价值[J].保健医学研究与实践,2025,22(1):67-73,7.基金项目
广东省医学科学技术研究基金项目(A2018416 （）
B2024137). （）
