Respiratory tract infection after oral and maxillofacial surgery under general anesthesia and related factors

Abstract

Introduction: We aimed to explore the respiratory tract infection after oral and maxillofacial surgery under general anesthesia and related factors

Methodology: A total of 494 patients receiving oral and maxillofacial surgery under general anesthesia with tracheal intubation were assigned to a non-infection group (n=469) and an infection group (n=25). Another 494 healthy people undergoing physical examination in the same period were enrolled to establish a classification tree model. The distribution of pathogens, drug resistance of main pathogens, and related influencing factors of postoperative respiratory tract infection were analyzed. The influencing factors of respiratory tract infection were screened by logistic regression analysis. After construction of the classification and regression tree (CART) model based on the influencing factors, the accuracy was evaluated by plotting receiver operating characteristic (ROC) curve.

Results: Pseudomonas aeruginosa was highly resistant to cefazolin and more sensitive to cefoperazone, ciprofloxacin, norfloxacin and imipenem. Staphylococcus aureus was highly resistant to gentamicin and more sensitive to vancomycin. Age ≥ 60 years old, history of lung diseases, operation time ≥ 4 h, anesthesia ventilation time ≥ 120 min, and orotracheal intubation were independent influencing factors of respiratory tract infection (p< 0.05). The results of the gain chart, index map, and Risk value indicated a high predictive value of the CART model for the risk of postoperative respiratory tract infection. The area under the ROC curve was 0.869 [95% confidence interval: 0.795-0.947].

Conclusions: The CART model has a high predictive value and may reduce the risk of postoperative infection.