A nomogram prediction of pressure sores in patients underwent fracture surgery / 中国实用护理杂志

ABSTRACT

Objective To analyze the risk factors of pressure sores in patients underwent fracture surgery to establish a nomogram model to predict the risk of pressure sores. Methods From June 2012 to June 2017,3 796 patients underwent fracture surgery were enrolled in this study.Their clinical data were analyzed and univariate analysis was used to determine the risk factors related to pressure sores. The significant variables were included in the multivariate Logistic regression analysis to analyze the risk factors of pressure sores. Then the R software was used to establish a predictive nomogram model. Bootstrap method was used to validate the nomogram model and ROC curve was used to explore the predictive efficacy of the model in predicting the pressure sores. Results A total of 392 cases out of 3 796 cases of fracture surgery had pressure sores.The prevalence rate was 10.33%(392/3 796).Age(OR=3.56,95% CI 1.84-5.21),obesity(OR=2.25,95% CI 1.27-3.69),malnutrition(OR=3.91,95% CI 1.90-5.87), diabetes mellitus (OR=2.73,95% CI 1.50-4.32), and surgery time over 2.5 h (OR=5.14,95% CI 2.81-7.25) were all independent risk factors for pressure sores in fracture surgery (P<0.05). The nomogram model showed a C-index of 0.749 with good discrimination and accuracy,while ROC curve showed that the area under the curve for the nomogram model predicting pressure sores was 0.727 (95% CI 0.661-0.815). Conclusions The nomogram built based on age, obesity, malnutrition, diabetes mellitus, and surgery time over 2.5 h has good discrimination and accuracy which could be helpful for screening the patients with high risk and making the interventional strategies.