Table 3.
Risk Factors for Early Postoperative Infection After Elective Gastric Cancer Surgery: Univariable and Multivariable Logistic Regression Analyses
| Variable | Univariable Analysis | Multivariable Analysis | ||
|---|---|---|---|---|
| OR (95% CI) | P value | OR (95% CI) | P value | |
| Age, years | 1.032 (1.011 to 1.053) | 0.002 | 1.027 (1.004 to 1.050) | 0.020 |
| Male sex | 1.381 (0.850 to 2.246) | 0.193 | 1.177 (0.703 to 1.970) | 0.536 |
| Body mass index≥30, kg/m2 | 0.943 (0.278 to 3.204) | 0.925 | 1.210 (0.344 to 4.253) | 0.767 |
| Smoking history | 1.232 (0.827 to 1.834) | 0.305 | ||
| Drinking history | 0.927 (0.600 to 1.431) | 0.732 | ||
| History of stroke | 1.274 (0.521 to 3.115) | 0.595 | ||
| Coronary heart disease | 1.804 (0.875 to 3.720) | 0.110 | 1.725 (0.795 to 3.745) | 0.168 |
| Hypertension | 1.385 (0.905 to 2.120) | 0.134 | 1.373 (0.864 to 2.183) | 0.180 |
| Arrhythmia | 2.872 (1.090 to 7.566) | 0.033 | 1.792 (0.612 to 5.252) | 0.287 |
| Diabetes | 0.641 (0.314 to 1.311) | 0.223 | 0.643 (0.319 to 1.294) | 0.215 |
| Hepatic dysfunction | 1.701 (0.682 to 4.242) | 0.255 | ||
| Renal dysfunction | 0.573 (0.074 to 4.454) | 0.595 | ||
| COPDa | 0 | 0.998 | ||
| ASA grade (III vs I and II) | 1.021 (0.582 to 1.793) | 0.942 | ||
| Preoperative WBC count >10×109/L | 0.770 (0.418 to 1.420) | 0.403 | ||
| Preoperative albumin <35 g/L | 2.701 (1.384 to 5.270) | 0.004 | 2.392 (1.163 to 4.920) | 0.018 |
| Preoperative anemiab | 0 | 0.999 | ||
| Preoperative chemotherapy | 0.767 (0.502 to 1.171) | 0.220 | ||
| Pathological diagnosis (adenocarcinoma vs others)c | 0.829 (0.474 to 1.453) | 0.513 | ||
| pTNM (IIB, III, IV vs IA, IB, IIA)d | 1.037 (0.670 to 1.544) | 0.858 | ||
| Differentiation grade (low or NA vs moderate or high) |
0.826 (0.553 to 1.233) | 0.350 | ||
| Range of gastrectomy (total vs distal or proximal gastrectomy) | 2.545 (1.683 to 3.847) | 0.000 | 2.227 (1.443 to 3.437) | 0.000 |
| Type of procedure (laparoscopic vs open gastrectomy) | 0.773 (0.485 to 1.233) | 0.280 | ||
| Duration of surgery | 1.006 (1.003 to 1.009) | 0.000 | 1.003 (1.000 to 1.007) | 0.056 |
| Type of anesthesia (balance vs inhalation anesthesia) | 0.810 (0.510 to 1.285) | 0.370 | ||
| Use of propofol | 0.816 (0.514 to 1.295) | 0.388 | ||
| Use of etomidate | 0.801 (0.510 to 1.259) | 0.336 | ||
| Inhalational anesthetics (isoflurane vs sevoflurane) | 1.487 (0.729 to 3.032) | 0.275 | ||
| Sufentanil equivalent (<255 ug vs ≥255 ug)e | 0.999 (0.997 to 1.001) | 0.212 | ||
| Estimated blood loss | 1.001 (0.999 to 1.002) | 0.140 | 1.000 (0.999 to 1.001) | 0.607 |
| Intraoperative blood transfusionf | 2.346 (0.625 to 8.799) | 0.206 | ||
| Intraoperative artificial colloid | 1.000 (0.999 to 1.001) | 0.941 | ||
| Intraoperative crystalloids | 1.000 (1.000 to 1.001) | 0.041 | 1.000 (1.000 to 1.001) | 0.568 |
| Perioperative glucocorticoids (DXM equivalent)g | 0.971 (0.944 to 0.998) | 0.037 | 0.968 (0.939 to 0.997) | 0.029 |
| SBP <90 mmHg for >10 min | 1.818 (1.040 to 3.178) | 0.036 | 2.112 (1.174 to 3.801) | 0.013 |
Notes: P values in bold indicate P<0.20 on univariable analyses and P<0.05 on multivariable analyses. aIncludes COPD (chronic bronchitis and emphysema), asthma, and old tuberculosis. bFor adult men, hemoglobin <120 g/L; for adult women, hemoglobin <110 g/L. cIncludes signet-ring cell carcinoma, adenocarcinoma combined signet-ring cell carcinoma, neuroendocrine tumor, lymphoid stromal carcinoma, melanoma, and squamous cell carcinoma. dAccording to the American Joint Committee on Cancer 8th Edition Cancer Staging System. e1 mg of morphine (iv) = 15 µg of fentanyl = 1.5 µg of sufentanil = 1 mg of oxycodone = 1 mg of dezocine.23–25 fPacked red blood cells were transfused. gIncludes dexamethasone and methylprednisolone; 1 mg of methylprednisolone = 0.2 mg of dexamethasone.22
Abbreviations: ASA, American Society of Anesthesiologists; COPD, chronic obstructive pulmonary disease; DXM, dexamethasone; NA, not available; pTNM, pathologic tumor-node-metastasis; SBP, systolic blood pressure; WBC, white blood cell.