Incidence and risk factors of poor wound healing following emergency surgery for intestinal tuberculosis

Table 1 Comparison of basic characteristics between two groups, n (%)

Item	Poor wound healing group (n = 22)	Good wound healing group (n = 93)	Test statistic	P value
Age (years)	52.1 ± 14.8	43.6 ± 15.0	t = 2.43	0.017
Gender			χ2 = 0.89	0.345
Male	15 (68.2)	53 (57.0)
Female	7 (31.8)	40 (43.0)
BMI (kg/m2)	18.9 ± 2.7	21.4 ± 3.1	t = 3.56	< 0.001
Education level			χ2 = 6.23	0.044
Junior high school or below	16 (72.7)	48 (51.6)
High school or above	6 (27.3)	45 (48.4)
Marital status			χ2 = 0.32	0.571
Married	18 (81.8)	79 (84.9)
Unmarried/divorced	4 (18.2)	14 (15.1)
Smoking history	12 (54.5)	31 (33.3)	χ2 = 3.84	0.050
Alcohol consumption history	8 (36.4)	25 (26.9)	χ2 = 0.89	0.345
Previous surgical history	9 (40.9)	21 (22.6)	χ2 = 3.51	0.061
Diabetes history	8 (36.4)	12 (12.9)	χ2 = 7.89	0.005

BMI: Body mass index.

Table 2 Comparison of preoperative laboratory indicators between two groups, mean ± SD

Item	Poor wound healing group (n = 22)	Good wound healing group (n = 93)	Test statistic	P value
Hemoglobin (g/L)	89.6 ± 12.4	106.8 ± 15.3	t = 4.87	< 0.001
Albumin (g/L)	28.3 ± 4.2	34.7 ± 5.8	t = 4.91	< 0.001
Total protein (g/L)	58.2 ± 8.3	66.4 ± 9.1	t = 3.91	< 0.001
Blood glucose (mmol/L)	7.8 ± 2.9	6.2 ± 1.8	t = 2.87	0.005
C-reactive protein (mg/L)	89.7 ± 31.2	52.4 ± 24.6	t = 5.63	< 0.001
ESR (mm/hour)	78.5 ± 26.3	58.9 ± 22.1	t = 3.42	0.001
Lymphocyte count (× 109/L)	0.96 ± 0.32	1.28 ± 0.41	t = 3.41	0.001
Neutrophil-to-lymphocyte ratio	8.7 ± 3.2	5.4 ± 2.1	t = 5.12	< 0.001

ESR: Erythrocyte sedimentation rate.

Table 3 Comparison of imaging characteristics between two groups, n (%)

Item	Poor wound healing group (n = 22)	Good wound healing group (n = 93)	Test statistic	P value
Ascites volume			Z = -2.89	0.004
Small amount (< 500 mL)	5 (22.7)	46 (49.5)
Moderate amount (500-1000 mL)	8 (36.4)	35 (37.6)
Large amount (> 1000 mL)	9 (40.9)	12 (12.9)
Degree of intestinal obstruction			Z = -2.34	0.019
No obstruction	3 (13.6)	28 (30.1)
Incomplete obstruction	12 (54.5)	52 (55.9)
Complete obstruction	7 (31.8)	13 (14.0)

Table 4 Distribution of postoperative poor wound healing types

Classification method	Number of cases (n)	Proportion (%)
By type of healing complication
Wound infection	14 cases	63.6
Wound dehiscence	5 cases	22.7
Delayed wound healing	3 cases	13.6

Table 5 Univariate logistic regression analysis of factors affecting postoperative poor wound healing

Variable	β	SE	Wald χ2	P value	OR	95%CI
Age ≥ 60 years	1.186	0.485	5.982	0.014	3.27	1.27-8.42
BMI < 18.5 kg/m2	1.524	0.496	9.451	0.002	4.59	1.73-12.17
Education (junior high school or below)	0.892	0.509	3.066	0.080	2.44	0.90-6.61
Smoking history	0.873	0.457	3.651	0.056	2.39	0.98-5.85
Previous surgical history	0.821	0.482	2.906	0.088	2.27	0.88-5.85
Diabetes history	1.321	0.515	6.588	0.010	3.75	1.37-10.26
Hemoglobin < 90 g/L	1.634	0.468	12.186	< 0.001	5.12	2.05-12.79
Albumin < 30 g/L	1.723	0.479	12.952	< 0.001	5.60	2.19-14.32
Total protein < 60 g/L	1.298	0.465	7.780	0.005	3.66	1.47-9.12
Blood glucose > 7.0 mmol/L	0.956	0.458	4.354	0.037	2.60	1.06-6.38
CRP > 50 mg/L	1.687	0.451	14.012	< 0.001	5.41	2.24-13.06
ESR > 70 mm/hour	1.201	0.462	6.750	0.009	3.32	1.34-8.22
Lymphocyte count < 1.0 × 109/L	1.156	0.471	6.017	0.014	3.17	1.26-7.98
Neutrophil-to-lymphocyte ratio > 7.0	1.542	0.468	10.844	0.001	4.67	1.87-11.66
Large volume ascites (> 1000 mL)	1.424	0.525	7.348	0.007	4.15	1.48-11.62
Complete intestinal obstruction	1.089	0.566	3.702	0.054	2.97	0.98-9.01

SE: Standard error; OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate.

Table 6 Multivariate logistic regression analysis of independent risk factors for postoperative poor wound healing

Variable	β	SE	Wald χ2	P value	OR	95%CI
Age ≥ 60 years	1.138	0.510	4.978	0.025	3.12	1.15-8.47
BMI < 18.5 kg/m2	1.442	0.517	7.774	0.005	4.23	1.54-11.61
Diabetes history	1.239	0.557	4.954	0.026	3.45	1.16-10.27
Albumin < 30 g/L	1.587	0.535	8.794	0.003	4.89	1.72-13.91
CRP > 50 mg/L	1.330	0.527	6.378	0.011	3.78	1.35-10.58

Hosmer-Lemeshow test for the model: χ² = 6.73, P = 0.566; model discriminatory ability: Area under the receiver operating characteristic curve = 0.841 (95% confidence interval: 0.762-0.920); multicollinearity test: Variance inflation factor values for all variables < 2.5, indicating no significant multicollinearity problem; model fit test: -2 Log-likelihood = 89.34, model χ² = 45.67 (P < 0.001). OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; CRP: C-reactive protein.

Table 7 Comparison of secondary observation indicators between two groups, n (%)/mean ± SD

Item	Poor wound healing group (n = 22)	Good wound healing group (n = 93)	Test statistic	P value
Time to complete wound healing (days)	28.6 ± 8.4	16.2 ± 4.3	t = 7.89	< 0.001
VAS pain scores
Postoperative day 3	6.2 ± 1.8	4.5 ± 1.6	t = 4.23	< 0.001
Postoperative day 7	4.9 ± 1.5	3.1 ± 1.2	t = 5.67	< 0.001
Postoperative day 14	3.4 ± 1.3	1.8 ± 0.9	t = 6.12	< 0.001
Wound scarring			χ2 =12.43	0.002
Mild	4 (18.2)	52 (55.9)
Moderate	12 (54.5)	35 (37.6)
Obvious	6 (27.3)	6 (6.5)
Anti-tuberculosis treatment compliance			χ2 = 5.64	0.018
Good (≥ 80%)	12 (54.5)	72 (77.4)
Fair (60%-79%)	7 (31.8)	16 (17.2)
Poor (< 60%)	3 (13.6)	5 (5.4)
Postoperative intra-abdominal infection rate	8 (36.4)	9 (9.7)	χ2 = 11.67	0.001

VAS: Visual analog scale.