喉癌根治性切除术患者术后感染影响因素分析及预测模型构建OA

Objective To analyze the influencing factors for postoperative infection in patients undergoing radical resection of laryngeal cancer and to construct a prediction model.Methods A total of 174 patients who underwent radical resection for laryngeal cancer at the First Affiliated Hospital of Nanjing Medical University from January 2023 to April 2025 were included.According to the occurrence of postoperative infection,they were divided into an infection group(51 cases)and a non-infection group(123 cases).Clinical data were compared between the two groups to analyze independent influencing factors for postoperative infection.A multivariate logistic regression model for postoperative infection was constructed and its value was evaluated.Using a random sampling method,the 174 patients were divided into a training set(121 cases)and a validation set(53 cases)at a ratio of 7:3.The training set was used for model construction,and the validation set was used for model validation.Results The incidence of postoperative infection among the 174 patients was 29.31％(51/174).Patients in the infection group were older,had longer operation time,had significantly higher proportions of concurrent chronic lung disease and tracheostomy stoma exudation,and had a significantly lower preoperative serum albumin level compared to the non-infection group,with all differences being statistically significant(P<0.05).Multivariate logistic regression analysis revealed that older age,longer operation time,concurrent chronic lung disease,and the presence of tracheostomy stoma exudation were independent risk factors for postoperative infection,while a high preoperative serum albumin level was an independent protective factor(P<0.05).Validation results of the prediction model showed that the areas under the curve for the training set and validation set were 0.97(95％CI:0.94-1.00)and 0.97(95％CI:0.93-1.00),respectively.The chi-square values of the Hosmer-Lemeshow goodness-of-fit test for the two sets were 6.736 and 5.834(both P>0.05).Decision curve analysis indicated that the model provided better clinical net benefit when the threshold probability was between 0.01 and 1.00 for the training set and between 0.02 and 1.00 for the validation set.Conclusion Age,preoperative serum albumin level,operation time,concurrent chronic lung disease,and the presence of tracheostomy stoma exudation are closely related to postoperative infection in patients undergoing radical resection of laryngeal cancer.The nomogram prediction model constructed based on these indicators demonstrates high performance and clinical applicability.