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胸腔镜肺癌切除术带引流管患者伤口愈合不良的风险预测

Risk prediction of poor wound healing in patients with thoracoscopic lung cancer resection with drainage tube.

作者信息

Chen Yuguo, Ji Congying, Huang Chuan, Zhou Ting, Wang Xia

机构信息

Dressing Room of Surgical Outpatient Department, Beijing Hospital, National Center of Gerontology Beijing 100730, China.

Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Beijing 100021, China.

出版信息

Am J Cancer Res. 2023 Dec 15;13(12):6090-6098. eCollection 2023.

Abstract

This work established a risk prediction (RP) model for poor wound healing (PWH) in patients with thoracoscopic lung cancer (LC) resection (TLCR) after drainage tube placement to explore its application effect. 359 patients with TLCR were categorized into a good wound healing group (GWH group, 275 cases) and a poor wound healing group (PWH group, 84 cases) based on incision healing condition. The independent prediction risk factors (IPRFs) of PWH were analyzed and a RP model was constructed. 70% of the patients were classified as the model group (Mod group) and 30% were in the validation group (Val group). Resolution of the RP model was evaluated by the area under receiver operating characteristic (ROC) curve (AUC). The Hosmer-Lemeshow goodness of fit (HLGF) test was employed to evaluate the calibration of RP model. Results from the multivariate logistic regression analysis (MLRA) showed that age, preoperative albumin levels, diabetes history, dressing change frequency, and type of wound cleaning fluid were independent risk factors (IRFs) for postoperative PWH (<0.05). In the Mod group, AUC=0.758 (<0.05, 95% CI=0.712-0.806), and HLGF test showed =0.493. In the Val group, AUC=0.783 (<0.05, 95% CI=0.675-0.834), and HLGF test showed =0.189. In conclusion, the constructed model was convenient, feasible, and demonstrates good predictive performance for postoperative incision healing issue, holding practical value and applicability.

摘要

本研究建立了胸腔镜肺癌(LC)切除术(TLCR)置管引流后患者伤口愈合不良(PWH)的风险预测(RP)模型,以探讨其应用效果。根据切口愈合情况,将359例行TLCR的患者分为伤口愈合良好组(GWH组,275例)和伤口愈合不良组(PWH组,84例)。分析PWH的独立预测风险因素(IPRFs)并构建RP模型。70%的患者被纳入模型组(Mod组),30%的患者被纳入验证组(Val组)。通过受试者操作特征(ROC)曲线下面积(AUC)评估RP模型的分辨力。采用Hosmer-Lemeshow拟合优度(HLGF)检验评估RP模型的校准情况。多因素逻辑回归分析(MLRA)结果显示,年龄、术前白蛋白水平、糖尿病史、换药频率和伤口清洁液类型是术后PWH的独立危险因素(IRFs)(<0.05)。在Mod组中,AUC = 0.758(<0.05,95%CI = 0.712 - 0.806),HLGF检验显示P = 0.493。在Val组中,AUC = 0.783(<0.05,95%CI = 0.675 - 0.834),HLGF检验显示P = 0.189。综上所述,构建的模型方便、可行,对术后切口愈合问题具有良好的预测性能,具有实际价值和适用性。

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