Construction of a Risk Factor Model for Wound Infection After Ileostomy for Rectal Cancer and Its Relationship with...

To establish a predictive model for wound infection after ileostomy for rectal cancer and its relationship with nucleotide-binding oligomerisation domain-like receptor thermal protein domain-associated protein 3 (NLRP3) gene polymorphism.

A total of 347 samples were randomly divided into two groups: the model group (n = 260) and the verification group (n = 87). The patients in the model group were further divided into the infection group (n = 96) and the non-infection group (n = 164). Multivariate logistic regression was used to analyse the influencing factors of postoperative infection. The TaqMan probe method was used for genotyping.

The results of multivariate logistic regression analysis showed that age >65 years, diabetes, operation time >105 minutes, loop colostomy and abnormal transepidermal water loss (TEWL) were independent risk factors. The risk value of postoperative wound infection predicted by the nomogram model reached 0.93, corresponding to a maximum predicted infection probability of 92.68%. The area under the receiver operating characteristic curve for the nomogram model was 0.869 (P < 0.001) and 0.861 (P < 0.001). The comparison of NLRP3 genotypes between the two groups showed that the proportion of the GG genotype was significantly higher in the infection group than the CC and CG genotypes (51.43% vs 29.90% and 38.98%, respectively). In patients with the GG genotype, the associations between age >65 years, diabetes and abnormal TEWL with wound infection remained significant (all P < 0.05), indicating that these clinical risk factors are particularly prevalent among GG carriers.

This study identified the independent risk factors for postoperative wound infection. Patients with the G allele have a higher risk of postoperative infection, and NLRP3 gene polymorphism is closely associated with the risk factors included in the model. The association between NLRP3 gene polymorphisms and the risk of postoperative infection provides a new molecular biological indicator for prognostic evaluation.