In the Department of Plastic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, Hang Xie, MS, is Master's Student; Ying Xiang, BN, is Head Nurse; E Yang, MM, is Attending Surgeon; and HengShu Zhang, MM, is Director of Plastic Surgery. Acknowledgments: This study was supported by the nursing research project of the First Affiliated Hospital of Chongqing Medical University (no. HLJJ2018-35) and the management research project of the First Affiliated Hospital of Chongqing Medical University (no. GLJJ2019-06). The authors have disclosed no financial relationships related to this article. Submitted September 26, 2020; accepted in revised form November 24, 2020.
Adv Skin Wound Care. 2021 Oct 1;34(10):1-6. doi: 10.1097/01.ASW.0000775924.92065.78.
To identify the risk factors of hypertrophic scarring (HS) after thyroidectomy and construct a risk prediction model.
From November 2018 to March 2019, the clinical data of patients undergoing thyroidectomy were collected for retrospective analysis. According to the occurrence of HS, the patients were divided into an HS group and a non-HS group. Univariate analysis and binary logistic regression analysis were conducted to explore the independent risk factors for HS. Receiver operating characteristic analysis was also carried out.
In this sample, 121 of 385 patients developed HS, an incidence of 31.4%. Univariate analysis showed significant differences in sex, age, postoperative infection, history of abnormal wound healing, history of pathologic scar, family history of pathologic scar, and scar prevention measures between the two groups (P < .05). Binary logistic regression analysis indicated that age 45 years or younger (odds ratio [OR], 1.815), history of abnormal wound healing (OR, 4.247), history of pathologic scarring (OR, 9.840), family history of pathologic scarring (OR, 5.708), and absence of preventive scar measures (OR, 5.566) were independent factors for HS after thyroidectomy. The area under the receiver operating characteristic curve was 0.837. When the optimal diagnostic cutoff value was 0.206, the sensitivity was 0.661, and the specificity was 0.932.
The development of HS after thyroidectomy is related to many factors, and the proposed risk prediction model based on the combined risk factors shows a good predictive value for postoperative HS. When researchers consider the prevention and treatment of scarring in patients at risk, the incidence of HS in different populations can provide theoretical support for clinical decision-making.
确定甲状腺切除术后增生性瘢痕(HS)的危险因素,并构建风险预测模型。
回顾性分析 2018 年 11 月至 2019 年 3 月期间行甲状腺切除术患者的临床资料。根据 HS 的发生情况,将患者分为 HS 组和非 HS 组。采用单因素分析和二元逻辑回归分析探讨 HS 的独立危险因素。同时进行受试者工作特征(ROC)曲线分析。
本样本中,385 例患者中有 121 例发生 HS,发生率为 31.4%。单因素分析显示,两组间性别、年龄、术后感染、异常伤口愈合史、病理性瘢痕史、病理性瘢痕家族史和瘢痕预防措施存在显著差异(P<0.05)。二元逻辑回归分析表明,年龄 45 岁或以下(比值比[OR],1.815)、异常伤口愈合史(OR,4.247)、病理性瘢痕史(OR,9.840)、病理性瘢痕家族史(OR,5.708)和无预防瘢痕措施(OR,5.566)是甲状腺切除术后发生 HS 的独立因素。ROC 曲线下面积为 0.837。当最佳诊断截断值为 0.206 时,灵敏度为 0.661,特异度为 0.932。
甲状腺切除术后 HS 的发生与多种因素有关,基于联合危险因素建立的风险预测模型对术后 HS 具有较好的预测价值。当研究人员考虑高危患者的瘢痕预防和治疗时,不同人群的 HS 发生率可为临床决策提供理论支持。