Clinical value of abdominal drainage fluid in the diagnosis and prediction of early abdominal infection after gastric cancer surgery
LYU Yang,HAN Tao,WANG Dong-hao
Department of Intensive Care Unit, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin＇s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin300060, China
Abstract:
Objective To explore clinical value of abdominal drainage fluid in early warning and prognosis evaluation of postoperative abdominal infection in gastric cancer patients. Methods A total of 130 gastric cancer patients who were admitted to ourhospital and underwent gastric cancer surgery between January 2017 and December 2020 were selected as study subjects. Record all clinical data of enrolled patients (patients with abdominal infections (77 cases) and non-abdominal infections (53 cases). Binary Logistics regression analysis was used to identify high-risk factors for predicting abdominal infection. Receiver operating characteristic (ROC) curves to evaluate predictive value of laboratory routine and biochemical indicators in postoperative abdominal drainage fluid for abdominal infection. Area under ROC curve (AUC) was calculated and compared. Cox regression analysis and K-M analysis were used to compare predictive value of different indicators for outcome and prognosis of patients with abdominal infections. Results There were statistically significant differences in APACHE Ⅱ score, SOFA score, peritoneal fluid leukocyte count, peritoneal fluid glucose, blood leukocyte count, blood glucose/peritoneal fluid glucose ratio, blood PCT, and ICU stay time between two groups; APACHE Ⅱ score, T2 stage, T4a stage, N1-N3, and blood glucose were independent risk factors for postoperative abdominal infection; AUC area of blood glucose/abdominal fluid glucose ratio was largest, and cut-off value was 1.6439. When blood glucose/abdominal fluid glucose ratio is greater than 1.6439, possibility of abdominal infection is significantly increased. Percentage of polymorphonuclear cells in abdominal drainage increasing and utilized of antibiotics during ICU were risk factors that affect ICU outcome and ICU stay time. Patients with abdominal infections have longer ICU stays than control group, and patients with blood glucose/abdominal drainage glucose ratio<1.6439 have slightly shorter ICU stay time than that with ratio≥1.6439. Conclusion "blood glucose/abdominal drainage glucose ratio" can be used as a key indicator for early prediction of abdominal infection, and patients with a ratio≥1.6439 have a significantly increased risk of abdominal infection.
