Prediction of surgical site infection after lung resection

Abstract

The aim of the study was to identify indicators of surgical site infection after lung resection and to develop a predictive model for this complication. The retrospective analysis included 464 patients who underwent lobectomy or wedge lung resection through lateral or anterolateral thoracotomy at the Department of Thoracic Oncology Surgery of the Regional Clinical Oncology Dispensary in 2021‑2023. Patients were divided into groups according to the presence or absence of wound infection; clinical, anamnestic, laboratory and intraoperative parameters were analyzed. The incidence of surgical site infection was 6.1 % (28 of 464 patients). Univariate analysis identified age, length of hospital stay, blood loss volume, duration of surgery, extent of surgery, diabetes mellitus, obesity, neutrophil-to-lymphocyte ratio, prognostic nutritional index, prolonged air leak, surgical complications, and neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios on postoperative day 3 as significant parameters. Multivariate logistic regression showed an independent association with the outcome for age, blood loss volume, diabetes mellitus, neutrophil-to-lymphocyte ratio and prognostic nutritional index. The area under the ROC curve was 0.974+ / –0.007; the sensitivity and specificity of the model were 97.0 % and 89.3 %, respectively. Based on these data, a nomogram and an interactive calculator were developed to assess the risk of wound infection after lung resection in thoracic surgical practice.