Li Mei, Nie Yijun, Yang Zhiyong
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University/Difficult and Critical Illness Center, Pediatric Clinical Medical Research Center of Guangxi, Nanning, 530022, China.
Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, China.
BMC Cardiovasc Disord. 2024 Dec 4;24(1):698. doi: 10.1186/s12872-024-04378-w.
Infections occurring postoperatively in pediatric patients with congenital heart disease (CHD) following cardiopulmonary bypass (CPB) surgery pose a considerable challenge, affecting the duration of hospitalization, financial costs, and patient outcomes. Studies investigating the association between systemic immune-inflammation index (SII) and early infections after CHD surgery are very rare. This study seeks to delineate the link between SII and the occurrence of early nosocomial infections in pediatric patients undergoing CPB surgery for CHD.
A cross-sectional analysis was performed on 325 pediatric patients who underwent CPB surgery for CHD between July 2020 and June 2023. The primary exposure was the SII value on the first postoperative day. The outcome was the occurrence of nosocomial infections within the first week following CPB surgery. Multivariable logistic regression models and subgroup analyses were employed to evaluate the association between SII and the risk of early nosocomial infections.
The median age of the study cohort was 4.4 years, with a male preponderance of 51.7%. The median SII value was recorded at 0.6 × 10^12/L. The rate of nosocomial infections within the first week post-CPB surgery was 53.5%. An inverse association was observed between SII and the incidence of early nosocomial infections. After controlling for multiple confounders, an increment of 1 × 10^12/L in SII corresponded to a 25% reduction in the likelihood of nosocomial infections (OR = 0.75; 95%CI: 0.57, 0.99; P = 0.044). Subgroup analyses substantiated the consistency of these findings.
The study demonstrated that an elevated SII corresponded to a reduced likelihood of early nosocomial infections after CPB surgery in children with CHD, a finding that merits additional investigation.
先天性心脏病（CHD）患儿在体外循环（CPB）心脏手术后发生的感染是一项重大挑战，会影响住院时间、经济成本和患者预后。研究系统性免疫炎症指数（SII）与CHD手术后早期感染之间关联的研究非常少见。本研究旨在阐明SII与接受CPB手术治疗CHD的儿科患者早期医院感染发生之间的联系。
对2020年7月至2023年6月期间接受CPB手术治疗CHD的325例儿科患者进行横断面分析。主要暴露因素为术后第一天的SII值。观察指标为CPB手术后第一周内医院感染的发生情况。采用多变量逻辑回归模型和亚组分析来评估SII与早期医院感染风险之间的关联。
研究队列的中位年龄为4.4岁，男性占比51.7%。SII值中位数记录为0.6×10^12/L。CPB手术后第一周内医院感染率为53.5%。观察到SII与早期医院感染发生率呈负相关。在控制多个混杂因素后，SII每增加1×10^12/L，医院感染的可能性降低25%（OR = 0.75；95%CI：0.57，0.99；P = 0.044）。亚组分析证实了这些发现的一致性。
该研究表明，CHD患儿CPB手术后SII升高与早期医院感染可能性降低相关，这一发现值得进一步研究。
