闭合性 Pilon 骨折术后手术部位感染的危险因素和列线图预测模型。

Risk factors and nomogram predictive model of surgical site infection in closed pilon fractures.

机构信息

Department of Orthopaedic, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China.

School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China.

出版信息

J Orthop Surg Res. 2023 Aug 8;18(1):582. doi: 10.1186/s13018-023-04058-z.

DOI:10.1186/s13018-023-04058-z

PMID:37553679

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10408134/

Abstract

OBJECTIVES

In this study, we try to investigate the risk factors of postoperative surgical site infection (SSI) in closed pilon fractures and establish a nomogram prediction model.

METHODS

From January 2012 to June 2021, 516 closed pilon fracture patients were included in this study. Of these, 387 patients were randomly assigned to the training group and 129 patients were assigned to the validation group (3:1). By univariate and multivariate Cox analysis, we identified independent risk factors for postoperative SSI after Pilon fracture. We established a nomogram model and used receiver operating characteristic (ROC) and calibration chart to evaluate its discriminant and calibration.

RESULTS

SSI occurred in 71 patients in the training group and 23 patients in the validation group. Ultimately, age, preoperative blood sugar, operative time, Tscherne classification and fracture classification were identified as independent risk factors for SSI. The AUC values for SSI of the training and validation group were 0.898 and 0.880, and the P value of the Hosmer-Lemeshow test was 0.125. We established a nomogram prediction model based on age, preoperative blood sugar, operative time, Tscherne classification and fracture classification.

CONCLUSION

Our nomogram model had good discrimination and calibration power, so it could be used to predict SSI risk in patients with pilon fracture.

摘要

目的

本研究旨在探讨闭合性 Pilon 骨折术后手术部位感染（SSI）的危险因素，并建立列线图预测模型。

方法

2012 年 1 月至 2021 年 6 月，共纳入 516 例闭合性 Pilon 骨折患者。其中，387 例患者被随机分配至训练组，129 例患者被分配至验证组（3:1）。通过单因素和多因素 Cox 分析，我们确定了 Pilon 骨折术后 SSI 的独立危险因素。我们建立了列线图模型，并使用接收者操作特征（ROC）曲线和校准图来评估其判别和校准能力。

结果

在训练组中，71 例患者发生 SSI，在验证组中，23 例患者发生 SSI。最终，年龄、术前血糖、手术时间、Tscherne 分类和骨折分类被确定为 SSI 的独立危险因素。训练组和验证组的 SSI 曲线下面积（AUC）分别为 0.898 和 0.880，Hosmer-Lemeshow 检验的 P 值为 0.125。我们基于年龄、术前血糖、手术时间、Tscherne 分类和骨折分类建立了列线图预测模型。