Value of inflammatory mediator profiles and procalcitonin in predicting postoperative infection in patients with hypertensive cerebral hemorrhage

Table 1 Distribution of postoperative infection sites in hypertensive cerebral hemorrhage patients

Infection site	Cases (n = 80)	Proportion (%)
Respiratory system	51	63.75
Surgical incision	15	18.75
Urinary system	9	11.25
Intracranial	5	6.25

Table 2 Distribution of postoperative pathogenic bacteria in patients with hypertensive cerebral hemorrhage

Pathogens	Strains (n)	Proportion (%)
Gram-negative bacteria	67	61.47
Klebsiella pneumoniae	24	22.02
Escherichia coli	18	16.51
Pseudomonas aeruginosa	13	11.93
Acinetobacter baumannii	8	7.34
Enterobacter cloacae	4	3.67
Gram-positive bacteria	32	29.36
Staphylococcus aureus	13	11.93
Staphylococcus epidermidis	9	8.26
coagulase-negative staphylococci	7	6.42
Enterococcus	3	2.75
Fungus	10	9.17
Total	109	100.00

Table 3 Comparison of general clinical data of the two groups of patients, n (%) or mean ± SD

Index	Infection group (n = 80)	Non-infection group (n = 191)	t/χ2 value	P value
Sex			0.586	0.444
Male	57 (71.25)	127 (66.49)
Female	23 (28.75)	64 (33.51)
Age (yr)	68.49 ± 9.67	67.52 ± 10.31	0.719	0.473
BMI (kg/m2)	23.67 ± 2.51	24.06 ± 2.74	1.095	0.275
Underlying diseases			4.844	0.028
Yes	49 (61.25)	89 (46.60)
No	31 (38.75)	102 (53.40)
Smoking history			0.865	0.352
Yes	35 (43.75)	72 (37.70)
No	45 (56.25)	119 (62.30)
GCS score (points)	6.85 ± 1.26	7.24 ± 1.68	1.867	0.063
Bleeding site			-	0.613
Lobe	49 (61.25)	103 (53.93)
Thalamus	19 (23.75)	53 (27.75)
Basal Ganglia	7 (8.75)	25 (13.09)
Brain stem	5 (6.25)	10 (5.24)
Bleeding (mL)	50.46 ± 10.63	48.35 ± 9.78	2.327	0.021

BMI: Body mass index; GCS: Glasgow coma scale.

Table 4 Comparison of inflammatory mediator profile indices and procalcitonin levels between the two groups of patients, pre- and postoperatively (mean ± SD)

Index	Infection group (n = 80)	Non-infection group (n = 191)	t/χ2 value	P value
IL-2 (ng/L)
Preoperative	1.28 ± 0.35	1.23 ± 0.24	1.356	0.176
POD	2.62 ± 0.87a	1.78 ± 0.53a	9.725	< 0.001
IL-4 (ng/L)
Preoperative	1.06 ± 0.31	0.98 ± 0.26	2.179	0.030
POD	3.68 ± 1.01a	2.35 ± 0.76a	11.873	< 0.001
IL-6 (ng/L)
Preoperative	3.21 ± 1.94	2.87 ± 0.88	3.447	0.001
POD	11.28 ± 3.27a	8.64 ± 2.13a	7.870	< 0.001
IL-10 (ng/L)
Preoperative	2.75 ± 0.89	2.53 ± 0.68	2.209	0.028
POD	8.72 ± 1.94a	6.53 ± 1.85a	8.762	< 0.001
TNF-α (ng/L)
Preoperative	1.73 ± 0.46	1.58 ± 0.51	2.272	0.024
POD	6.58 ± 2.04	3.91 ± 0.94	14.755	< 0.001
IFN-γ (ng/L)
Preoperative	0.86 ± 0.25	0.80 ± 0.19	2.151	0.032
POD	3.18 ± 0.97	2.76 ± 0.84	3.583	< 0.001
PCT (μg/L)
Preoperative	1.55 ± 0.42	0.51 ± 0.19	28.087	< 0.001
POD	1.83 ± 0.56a	0.63 ± 0.21a	25.667	< 0.001

^aP < 0.05 vs the same group preoperatively.

IL: Interleukin; POD: Postoperative day; TNF-α: Tumor necrosis factor-α; IFN-γ: Interferon-γ; PCT: Procalcitonin.

Table 5 Multivariate logistic regression analysis of postoperative infection in patients with hypertensive cerebral hemorrhage

Factors	β	SE	Wald χ2	OR	95%CI	P value
Underlying diseases	0.615	0.377	2.661	1.850	0.883-3.873	0.104
Bleeding	0.096	0.068	1.993	1.101	0.963-1.258	0.159
IL-4	0.876	0.478	3.359	2.401	0.941-6.128	0.068
IL-6	0.893	0.321	7.739	2.442	1.302-4.582	0.006
IL-10	0.483	0.282	2.934	1.621	0.933-2.817	0.087
TNF-α	0.473	0.289	2.679	1.605	0.911-2.828	0.102
IFN-γ	0.469	0.248	3.576	1.598	0.983-2.599	0.059
PCT	1.457	0.391	13.886	4.293	1.995-9.238	< 0.001

IL: Interleukin; TNF-α: Tumor necrosis factor-α; IFN-γ: Interferon-γ.

Table 6 Analysis of the predictive value of preoperative interleukin-6 and procalcitonin levels and their combined detection in postoperative infection in patients with hypertensive cerebral hemorrhage

Index	AUC	P value	Cutoff value	Younden’s Index	Sensitivity	Specificity
IL-6	0.755	0.003	3.10 ng/L	0.475	76.47	71.05
PCT	0.824	< 0.001	0.96 μg/L	0.692	82.35	86.84
Joint detection	0.866	< 0.001	-	0.711	90.00	81.05

IL: Interleukin; AUC: Area under the curve; PCT: Procalcitonin.