Factors Influencing Prognosis of Patients with Intra-Abdominal Infection and Its Value in Assessing Prognosis

Abstract

Background: To explore the distribution of pathogenic bacteria in patients with intra-abdominal infection, to clarify the independent factors that affect the prognosis of patients with intra-abdominal infection and its evaluation value for prognosis. Methods The pathogens, underlying diseases and related clinical data of patients with intra-abdominal infection from January 2012 to December 2019 in our hospital were retrospectively collected and the APACHE II score was calculated. The patients were divided into survival group and death group according to the prognosis, and the index between the two groups were compared. Spearman correlation analysis was used to evaluate the correlation between each index and prognosis, multivariate Logistic regression analysis was used to screen the independent prognostic factors. Results 282 patients were included in the study, including 183 males and 99 females, aged 56.99 ± 15.34 years. The survival group was 218cases, the death group was 64 cases, the total intra-abdominal infection mortality was 22.70%. There were significant differences between the two groups in age, serum albumin level, APACHE II score, basic cardiovascular disease and diabetes mellitus (P <0.05). Spearman correlation analysis showed that ALB level was negatively correlated with prognosis, age and APACHE II score were positively correlated with prognosis. Logistic regression analysis showed that age, ALB level and APACHE II score were independent prognostic factors. The area under the curve of the age, ALB level, APACHE II score and these three combined to assess the prognosis were 0.624, 0.698, 0.807 and 0.842 respectively. the sensitivity was 56.30%, 57.80%, 79.70% and 89.10% respectively, and the specificity was 69.30%, 75.20%, 68.80% and 65.10%, respectively. The formula of age combined ALB level and APACHE II score was Y= X1-3.6X2+6.5X3 (X1 was the age, X2 was the ALB level and X3 was the APACHE II score), Y was positively correlated with poor prognosis, and the optimal cutoff value was Y = 40.96. Conclusions Age, ALB level and APACHE II score are independent factors which influencing the prognosis of patients with intra-abdominal infection, and the combination of age, ALB level and APACHE II score can better assess the prognosis of patients with intra-abdominal infection.