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血小板与白蛋白比值作为溃疡性结肠炎患儿手术部位感染预测指标的临床评估

Clinical evaluation of platelet-to-albumin ratio as a predictor of surgical site infection in pediatric patients with ulcerative colitis.

作者信息

Higashi Koki, Koike Yuhki, Sato Yuki, Ruiya Ma, Yamashita Shinji, Nagano Yuka, Shimura Tadanobu, Kitajima Takahito, Matsushita Kohei, Okita Yoshiki, Okugawa Yoshinaga, Toiyama Yuji

机构信息

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.

出版信息

Surg Today. 2025 Feb 4. doi: 10.1007/s00595-025-02997-0.

DOI:10.1007/s00595-025-02997-0
PMID:39903232
Abstract

PURPOSE

This study explored the predictive factors for surgical site infection (SSI) in a pediatric ulcerative colitis (UC) population.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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本文引用的文献

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Platelet/Albumin ratio and plateletcrit levels are potential new biomarkers for assessing endoscopic inflammatory bowel disease severity.血小板/白蛋白比值和血小板比容水平可能是评估内镜下炎症性肠病严重程度的新的潜在生物标志物。
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Albumin and Associated Biomarkers in Severe Neuropsychiatric Disorders: Acute-Phase Schizophrenia and Bipolar Disorder.
严重神经精神疾病中的白蛋白及相关生物标志物:急性期精神分裂症和双相情感障碍
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The Prognostic Nutritional Index is a Predictive Marker for Postoperative Complications in Patients with Late-Onset Ulcerative Colitis.预后营养指数是预测晚发性溃疡性结肠炎患者术后并发症的预测指标。
World J Surg. 2023 Nov;47(11):2867-2875. doi: 10.1007/s00268-023-07118-x. Epub 2023 Jul 20.
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Role of platelet to albumin ratio for predicting persistent acute kidney injury in patients admitted to the intensive care unit.血小板与白蛋白比值在预测重症监护病房患者持续性急性肾损伤中的作用。
BMC Anesthesiol. 2023 Jul 19;23(1):242. doi: 10.1186/s12871-023-02137-6.
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