Risk factors and predictive model construction for surgical site infection after microvascular decompression

LI Yuanye; FANG Yanning; LU Wenpeng; HUO Dongdong

doi:10.11850/j.issn.1009-122X.2025.10.006

Abstract：Objective To analyze the risk factors for surgical site infection(SSI)after microvascular decompression(MVD)and construct a predictive model.Methods The clinical data of 645 patients who underwent MVD,were analyzed retrospectively.Based on the occurrence of SSI,they were divided into the infected group(n=55)and the non-infected group(n=590).Univariate analysis was used to compare the differences in clinical data between the two groups.Multivariate logistic regression analysis was employed to screen for the risk factors of SSI after MVD,and a regression equation for the incidence rate was constructed.Predictive ability analysis and internal validation were performed using goodness-of-fit tests,receiver operating characteristic(ROC)curves,and calibration curves.Results The incidence rate of SSI after MVD was 8.53%(55/645).Nine strains of pathogens were isolated,all of which were Gram-negative bacteria,with Klebsiella pneumoniae accounting for 66.67%(6/9).Logistic regression analysis revealed that the risk factors for SSI after MVD were hypoproteinemia,mastoid air cell opening,operation time≥3 h,cerebrospinal fluid leakage,and indwelling drainage tube(all P<0.05).The regression equation for the incidence rate of SSI was:Logit(P)=-9.218+1.187×hypoproteinemia+0.986×mastoid air cell opening+0.963×operation time(≥3 h)+2.436×cerebrospinal fluid leakage+3.412×indwelling drainage tube.The Hosmer-Lemeshow test indicated good model fit(P=0.696).The area under the curve(AUC)of this predictive model was 0.809(95%CI:0.743-0.869),with a sensitivity of 80.20%and a specificity of 73.10%,demonstrating good discrimination.The calibration curve showed good consistency of the model.Conclusions There is a certain incidence rate of SSI after MVD.The predictive model constructed based on the risk factors has high value in predicting SSI after MVD.Timely intervention targeting the risk factors can reduce the incidence rate of SSI.