Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Institute of Health & Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Int Wound J. 2018 Oct;15(5):686-694. doi: 10.1111/iwj.12911. Epub 2018 Mar 13.
The aim of this study was to validate a newly developed tool for predicting the risk of recurrence within 12 months of a venous leg ulcer healing. Performance of the tool to predict recurrence within a 12-month period was assessed using Area Under the Receiver Operating Characteristic Curve (AUC) analysis. Multi-site retrospective and prospective longitudinal studies were undertaken to validate a risk assessment tool for the recurrence of venous leg ulcers within 12 months. In the retrospective study (n = 250), 55% of venous leg ulcers recurred within 12 months, and the risk assessment total score had excellent discrimination and goodness of fit with an AUC of 0.83 (95% CI, 0.76-0.90, P < .001). The prospective study (n = 143) observed that 50.4% (n = 63) of venous leg ulcers recurred within 12 months of healing. Participants were classified using the risk assessment tool as being at low risk (28%), moderate risk (59%), and high risk (13%); the proportion of wounds recurring at 12 months was 15%, 61%, and 67% for each group, respectively. Validation results indicated good discrimination and goodness of fit, with an AUC of 0.73 (95% CI, 0.64-0.82, P < .001). Validation of this risk assessment tool for the recurrence of venous leg ulcers provides clinicians with a resource to identify high-risk patients and to guide decisions on adjunctive, tailored interventions to address the specific risk factors to decrease the risk of recurrence.
本研究旨在验证一种新开发的工具,用于预测静脉下肢溃疡愈合后 12 个月内的复发风险。使用接收者操作特征曲线下面积 (AUC) 分析评估该工具预测 12 个月内复发的性能。进行了多地点回顾性和前瞻性纵向研究,以验证一种静脉下肢溃疡 12 个月内复发风险的评估工具。在回顾性研究(n = 250)中,55%的静脉下肢溃疡在 12 个月内复发,风险评估总评分具有出色的区分度和拟合优度,AUC 为 0.83(95%CI,0.76-0.90,P<.001)。前瞻性研究(n = 143)观察到 50.4%(n = 63)的静脉下肢溃疡在愈合后 12 个月内复发。参与者使用风险评估工具分为低风险(28%)、中风险(59%)和高风险(13%);每个组在 12 个月时复发的伤口比例分别为 15%、61%和 67%。验证结果表明,该工具具有良好的区分度和拟合优度,AUC 为 0.73(95%CI,0.64-0.82,P<.001)。该静脉下肢溃疡复发风险评估工具的验证为临床医生提供了一种资源,以识别高风险患者,并指导针对特定风险因素的附加、定制干预措施,以降低复发风险。