Department of Gastrointestinal Surgery, Jiaozhou Central Hospital of Qingdao, No. 99 Yunxihe South Road, Jiaozhou, Shandong Province, 266300, China.
Department of Radiology, Jiaozhou Central Hospital of Qingdao, Qingdao, Shandong Province, China.
BMC Surg. 2024 Oct 9;24(1):297. doi: 10.1186/s12893-024-02541-w.
Surgical site infection (SSI) is common after laparoscopic appendectomy, resulting in prolonged hospital stay and increased costs. This study examined the relationship between body composition parameters and risk of incisional SSI in patients with complicated appendicitis.
We included 411 patients who underwent laparoscopic surgery for complicated appendicitis at a single institution between March 2015 and October 2023. Body composition parameters were derived from preoperative computed tomography (CT). A nomogram was constructed based on the independent predictors of incisional SSI.
Overall, 45 (10.9%) patients developed incisional SSI. Visceral fat area (VFA) was independently associated with risk of incisional SSI (hazard ratio 1.015, 95% confidence interval 1.010-1.020, P < 0.001). A nomogram integrating VFA and two other independent predictors (diabetes and conversion) demonstrated high discriminative (area under the curve = 0.793) and calibration abilities.
CT-derived VFA could be a valuable predictor of incisional SSI in patients with complicated appendicitis undergoing laparoscopic surgery. A VFA-based nomogram may help in identifying patients at high risk of SSI.
腹腔镜阑尾切除术后常发生手术部位感染（SSI），导致住院时间延长和费用增加。本研究探讨了体成分参数与复杂性阑尾炎患者切口 SSI 风险的关系。
我们纳入了 2015 年 3 月至 2023 年 10 月在一家机构接受腹腔镜手术治疗复杂性阑尾炎的 411 例患者。体成分参数来自术前计算机断层扫描（CT）。根据切口 SSI 的独立预测因素构建了一个列线图。
共有 45 例（10.9%）患者发生切口 SSI。内脏脂肪面积（VFA）与切口 SSI 风险独立相关（风险比 1.015，95%置信区间 1.010-1.020，P<0.001）。整合 VFA 和另外两个独立预测因素（糖尿病和中转开腹）的列线图显示出较高的区分能力（曲线下面积=0.793）和校准能力。
CT 衍生的 VFA 可能是腹腔镜手术治疗复杂性阑尾炎患者切口 SSI 的有价值预测指标。基于 VFA 的列线图可能有助于识别 SSI 风险较高的患者。
