School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
Wound Repair Regen. 2013 May-Jun;21(3):418-27. doi: 10.1111/wrr.12038. Epub 2013 Apr 16.
Identifying patients who benefit from hyperoxygenation therapy is important, because treatment is time-consuming and involves high costs and complications (minor). Our objective was to develop a model for predicting therapy outcome based on population of patients with and without diabetes. A retrospective cohort study was carried out in a major hospital in Israel. All 385 patients treated between 1/1/1998 and 1/1/2007 for ischemic nonhealing lower extremities wounds were included. Data on medical history, demographic, transcutaneous oximetry, wounds, treatment, and outcome characteristics were collected. Eight factors were identified to optimally predict wound healing: (1) number of hyperbaric oxygenation treatments (odds ratio [OR] = 1.034, p < 0.001), (2) transcutaneous oximetry values at hyperbaric conditions (OR = 1.001, p = 0.019), (3) wound duration (OR = 0.988, p = 0.022), (4) absence of heart disease (OR = 3.304, p < 0.001), (5) being employed (OR = 3.16, p = 0.008), (6) low socioeconomic status (OR = 2.50, p = 0.004), (7a) good/partial granulation wound appearance (OR = 2.73, p = 0.022), (7b) wounds covered with fibrin (OR = 3.16, p = 0.015), and (8) absence of anemia (OR = 2.13, p = 0.016). The model's sensitivity is 78.7%, specificity is 62.9%, and accuracy is 71.8%. We suggest using our model as an adjunct to patients' clinical evaluation. Also, we recommend initiating hyperoxygenation therapy no later than 2 months after wound appearance.
确定哪些患者受益于高氧治疗很重要，因为这种治疗既耗时又昂贵，还会带来轻微并发症。我们的目标是开发一种基于糖尿病患者和非糖尿病患者人群的治疗结果预测模型。这是一项在以色列一家大医院进行的回顾性队列研究。所有在 1998 年 1 月 1 日至 2007 年 1 月 1 日期间接受缺血性下肢不愈合伤口治疗的 385 名患者均纳入本研究。收集了患者的病史、人口统计学、经皮血氧饱和度、伤口、治疗和结局特征的数据。为了优化预测伤口愈合，我们确定了 8 个因素：（1）高压氧治疗次数（比值比 [OR] = 1.034，p < 0.001），（2）高压条件下的经皮血氧饱和度值（OR = 1.001，p = 0.019），（3）伤口持续时间（OR = 0.988，p = 0.022），（4）无心脏病（OR = 3.304，p < 0.001），（5）有工作（OR = 3.16，p = 0.008），（6）社会经济地位低（OR = 2.50，p = 0.004），（7a）良好/部分肉芽组织伤口外观（OR = 2.73，p = 0.022），（7b）伤口覆盖纤维蛋白（OR = 3.16，p = 0.015），以及（8）无贫血（OR = 2.13，p = 0.016）。该模型的灵敏度为 78.7%，特异性为 62.9%，准确性为 71.8%。我们建议将该模型作为患者临床评估的辅助手段。同时，我们建议在伤口出现后 2 个月内尽早开始高氧治疗。
