Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
Int Wound J. 2018 Apr;15(2):258-265. doi: 10.1111/iwj.12859. Epub 2017 Dec 26.
The aim of this study was to validate a newly developed tool that can predict the risk of failure to heal of a venous leg ulcer in 24 weeks. The risk assessment tool was validated, and performance of the tool was assessed using Area Under the Receiver Operating Characteristic Curve (AUC) analysis. Retrospective and prospective validation was conducted through multi-site, longitudinal studies. In the retrospective study (n = 318), 30% of ulcers did not heal within 24 weeks, with the tool demonstrating an AUC of 0.80 (95% CI, 0.68-0.93, P < .001) for the total score. In the prospective study across 10 clinical sites (n = 225), 31% (n = 68) of ulcers did not heal within 24 weeks. Participants were classified with the RAT at enrolment as being at low risk (27%), moderate risk (53%) or high risk (20%) of delayed healing; the proportion of wounds unhealed at 24 weeks was 6%, 29% and 59%, respectively. Validation results of the total score indicated good discrimination and goodness of fit with an AUC of 0.78 (95% CI, 0.71-0.85, P < .001). Validation of this risk assessment tool offers assurance that realistic outcomes can be predicted for patients, and scores can guide early decisions on interventions to address specific risk factors for failing to heal, thus promoting timely healing.
本研究旨在验证一种新开发的工具，该工具可以预测 24 周内静脉性腿部溃疡愈合失败的风险。通过接受者操作特性曲线（Receiver Operating Characteristic Curve，ROC）下面积（Area Under the Receiver Operating Characteristic Curve，AUC）分析来验证风险评估工具，并评估工具的性能。通过多地点、纵向研究进行回顾性和前瞻性验证。在回顾性研究（n=318）中，30%的溃疡在 24 周内未愈合，该工具的总评分 AUC 为 0.80（95%CI，0.68-0.93，P<0.001）。在跨越 10 个临床地点的前瞻性研究中（n=225），31%（n=68）的溃疡在 24 周内未愈合。在入组时，使用 RAT 将参与者分类为愈合延迟的低风险（27%）、中风险（53%）或高风险（20%）；24 周时未愈合的伤口比例分别为 6%、29%和 59%。总评分的验证结果表明，该工具具有良好的区分度和拟合优度，AUC 为 0.78（95%CI，0.71-0.85，P<0.001）。该风险评估工具的验证确保了可以为患者预测现实的结果，并且评分可以指导早期干预措施，以解决未能愈合的特定风险因素，从而促进及时愈合。
