WOFAPS 2025 8th World Congress of Pediatric Surgery

Purposes: Although postoperative pulmonary infection (POI) is recognized as a major complication occurs in pediatric patients after major abdominal surgery, little is known about the perioperative features, which contribute to POI . We here developed a nomogram to estimate the risk of POI after major abdominal surgery for pediatric patients.

Methods: There were a total of 1238 pediatric patients underwent a major abdominal surgery enrolled and retrospectively investigated. Perioperative parameters were subjected to constructing a nomogram for postoperative POI. The concordance of the model (C-index) and discrimination capability were confirmed by concordance index, calibration curves and receiver operating characteristic (ROC) analysis.

Results: Among the 1075 patients collected, 91 pediatric patients developed postoperative pulmonary infection (POI). The independent predictors for POI were verified using multivariable logistic regression analysis, including fever >37.5 °C, long operation time (hour), LCR, emergency surgery, and intra-operative blood transfusion. We next developed a nomogram using these five variables with good concordance and discrimination capability. The predictive accuracy was varified by ROC analysis, with sensitivity, and specificity of 87.6%, and 78.9%, respectively.

Conclusion: We successfully developed the nomogram, a clinical decision-making tool, to identify accurately the postoperative pulmonary infection (POI). The involved physicians when managed these patients should keep these variables in mind, which would benefit for postoperative recovery.