Higashi Koki, Koike Yuhki, Sato Yuki, Ruiya Ma, Yamashita Shinji, Nagano Yuka, Shimura Tadanobu, Kitajima Takahito, Matsushita Kohei, Okita Yoshiki, Okugawa Yoshinaga, Toiyama Yuji
Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 174 Edobashi 2-chome, Tsu, Mie, Japan.
Department of Genomic Medicine, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Surg Today. 2025 Feb 4. doi: 10.1007/s00595-025-02997-0.
This study explored the predictive factors for surgical site infection (SSI) in a pediatric ulcerative colitis (UC) population.
Data from 35 patients with UC who underwent surgery before 15 years at Mie University Hospital between January 2000 and December 2022 were retrospectively reviewed. Potential preoperative and intraoperative predictors of SSI, including various demographic and clinical variables, were analyzed using the Mann-Whitney U test and logistic regression analysis. The optimal cutoff value for the variables was determined by examining the receiver operating characteristic curve.
Of the 35 patients, 8 (22.9%) experienced SSI. The platelet-to-albumin ratio (PAR) is a more accurate predictor of SSI occurrence than the serum albumin level, platelet count, or C-reactive protein level. The sensitivity and specificity of PAR were 75.0% and 77.8%, respectively, with an area under the curve (AUC) of 0.782 (p = 0.018). A multivariable analysis revealed that preoperative PAR was the only significant independent predictor (cutoff value: 115,000, p = 0.047) when the optimal cutoff value was applied rather than the median value.
This study demonstrated the value of the preoperative PAR in the management of pediatric patients with UC. Assessing the patient's PAR before surgery allows proactive treatment to reduce the risk of SSI.
本研究探讨了小儿溃疡性结肠炎(UC)患者手术部位感染(SSI)的预测因素。
回顾性分析了2000年1月至2022年12月期间在三重大学医院接受手术的35例15岁以下UC患者的数据。使用Mann-Whitney U检验和逻辑回归分析,分析了包括各种人口统计学和临床变量在内的SSI潜在术前和术中预测因素。通过检查受试者工作特征曲线确定变量的最佳截断值。
35例患者中,8例(22.9%)发生了SSI。血小板与白蛋白比值(PAR)比血清白蛋白水平、血小板计数或C反应蛋白水平更能准确预测SSI的发生。PAR的敏感性和特异性分别为75.0%和77.8%,曲线下面积(AUC)为0.782(p = 0.018)。多变量分析显示,当应用最佳截断值而非中位数时,术前PAR是唯一显著的独立预测因素(截断值:115,000,p = 0.047)。
本研究证明了术前PAR在小儿UC患者管理中的价值。术前评估患者的PAR可进行积极治疗,以降低SSI风险。