Tsai Yueh-Ju, Lin Cen-Hung, Yen Yuan-Hao, Wu Cheng-Chun, Carvajal Carolina, Molte Nicolas Flores, Lin Pao-Yuan, Hsieh Ching-Hua
Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Front Surg. 2023 Mar 3;10:970681. doi: 10.3389/fsurg.2023.970681. eCollection 2023.
Many studies on the recurrence of pressure ulcers after surgical reconstruction have focused on surgical techniques and socioeconomic factors. Herein, we aimed to identify the risk factors of the associated comorbidities for pressure ulcer recurrence. We enrolled 147 patients who underwent pressure ulcer reconstruction and were followed up for more than three years. The recurrence of pressure ulcers was defined as recurrent pressure ulcers with stage 3/4 pressure ulcers. We reviewed and analyzed systematic records of medical histories, including sex, age, associated comorbidities such as spinal cord injury (SCI), diabetes mellitus (DM), coronary artery disease, cerebral vascular accident, end-stage renal disease, scoliosis, dementia, Parkinson's disease, psychosis, autoimmune diseases, hip surgery, and locations of the primary pressure ulcer. Patients with recurrent pressure ulcers were younger than those without. Patients with SCI and scoliosis had higher odds, while those with Parkinson's disease had lower odds of recurrence of pressure ulcers than those without these comorbidities. Moreover, the decision tree algorithm identified that SCI, DM, and age < 34 years could be risk factor classifiers for predicting recurrent pressure ulcers. This study demonstrated that age and SCI are the two most important risk factors associated with recurrent pressure ulcers following surgical reconstruction.
许多关于手术重建后压疮复发的研究都集中在手术技术和社会经济因素上。在此,我们旨在确定与压疮复发相关的合并症的风险因素。我们纳入了147例行压疮重建手术且随访超过三年的患者。压疮复发定义为出现3/4期压疮的复发性压疮。我们回顾并分析了系统的病史记录,包括性别、年龄、相关合并症,如脊髓损伤(SCI)、糖尿病(DM)、冠状动脉疾病、脑血管意外、终末期肾病、脊柱侧弯、痴呆、帕金森病、精神病、自身免疫性疾病、髋关节手术以及原发性压疮的部位。压疮复发患者比未复发患者更年轻。与无这些合并症的患者相比,患有SCI和脊柱侧弯的患者压疮复发几率更高,而患有帕金森病的患者压疮复发几率更低。此外,决策树算法确定SCI、DM和年龄<34岁可能是预测复发性压疮的风险因素分类指标。本研究表明,年龄和SCI是手术重建后与复发性压疮相关的两个最重要的风险因素。