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骨科手术后HIV感染患者手术部位感染的列线图预测:一项回顾性研究

Nomogram prediction of surgical site infection of HIV-infected patients following orthopedic surgery: a retrospective study.

作者信息

Ma Rui, He Jie, Xu Biao, Zhao Changsong, Zhang Yao, Li Xin, Sun Sheng, Zhang Qiang

机构信息

Department of Orthopaedics, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, Chaoyang District, Beijing, 100015, China.

出版信息

BMC Infect Dis. 2020 Nov 26;20(1):896. doi: 10.1186/s12879-020-05613-3.

Abstract

BACKGROUND

Surgical site infection (SSI) is a devastating complication of orthopedic surgery, related with increased morbidity and mortality. This study was performed with the aim to compare the SSI rate in human immunodeficiency virus HIV-positive patients, to identify other risk factors for SSI and to establish a nomogram model to predict the risk of SSI.

METHODS

A total of 101 HIV-positive individuals following orthopedic surgery patients admitted to Beijing Ditan Hospital. Their characteristics were gathered. The univariate and multiple logistic regression analysis were performed to explore the risk factors of SSI. And the Nomogram prediction model was constructed and verified.

RESULTS

The independent predictive factors of SSI included CD4 (Odds ratio [OR], 0.041; P = 0.040), erythrocyte sedimentation rate (ESR) (OR, 89.773; P = 0.030), and procalcitonin (PCT) (OR, 220.746; P = 0.006). The scoring nomogram model was as follows: Logit (SSI) = - 2.63589-0.00314CD4 < 430.75 = 1) + 0.04695(ESR < 17.46 = 1) + 2.93694*(PCT < 0.22 = 1). The area under the Receiver Operating Characteristic (ROC) curve was 0.946. The cutoff score was - 2.1026 with a sensitivity of 93.33% and a specificity of 84.88%.

CONCLUSIONS

CD4, ESR, PCT might affect the occurrence of SSI after orthopedic surgery. The nomogram model constructed in this study is helpful for predicting the probability of SSI.

摘要

背景

手术部位感染(SSI)是骨科手术中一种严重的并发症,与发病率和死亡率的增加相关。本研究旨在比较人类免疫缺陷病毒(HIV)阳性患者的SSI发生率,确定SSI的其他危险因素,并建立列线图模型以预测SSI风险。

方法

共纳入101例在北京地坛医院接受骨科手术的HIV阳性患者。收集他们的特征。进行单因素和多因素逻辑回归分析以探讨SSI的危险因素。并构建和验证列线图预测模型。

结果

SSI的独立预测因素包括CD4(比值比[OR],0.041;P = 0.040)、红细胞沉降率(ESR)(OR,89.773;P = 0.030)和降钙素原(PCT)(OR,220.746;P = 0.006)。评分列线图模型如下:Logit(SSI)= -2.63589 - 0.00314 *(CD4 < 430.75 = 1)+ 0.04695 *(ESR < 17.46 = 1)+ 2.93694 *(PCT < 0.22 = 1)。受试者操作特征(ROC)曲线下面积为0.946。截断分数为-2.1026,灵敏度为93.33%,特异度为84.88%。

结论

CD4、ESR、PCT可能影响骨科手术后SSI的发生。本研究构建的列线图模型有助于预测SSI的发生概率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5682/7690143/4c521ca2ab9d/12879_2020_5613_Fig1_HTML.jpg

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