老年面部皮肤肿瘤患者术后切口感染风险的临床预测模型的构建  

Construction of a Clinical Prediction Model for the Risk of Postoperative Incision Infection in Elderly Patients with Facial Skin Tumors

作　　者：程佳伟 施健[1] 张琪[1] 张俐 CHENG Jia-wei;SHI Jian;ZHANG Qi;ZHANG Li(Dermatological Department of Nantong First People's Hospital,Nantong 226006,Jiangsu,China)

机构地区：[1]南通市第一人民医院皮肤科,江苏南通226006

出　　处：《医学信息》2024年第8期46-51,共6页Journal of Medical Information

摘　　要：目的建立老年面部皮肤肿瘤患者术后切口感染风险的列线图预测模型并验证其预测能力。方法采用回顾性分析方法,收集2018年1月-2021年12月447例于本院行皮肤肿瘤切除术的老年患者病历资料,根据诊断标准分为感染组(31例)和非感染组(416例)。使用单因素分析和多因素Logistic回归分析确定术后感染的独立危险因素,并建立包含这些因素的列线图。通过Bootstrap抽样法进行内部验证,应用一致性指数(C-index)、受试者工作特征曲线(ROC曲线)、校准曲线、和决策曲线(DCA曲线)评估模型的预测能力。结果447例患者术后切口感染发生率为6.94%。单因素分析显示,两组吸烟史、糖尿病病史、手术部位、手术类型、术后抗生素使用、术后康复教育及护理比较,差异有统计学意义(P<0.05)。Logistic回归分析显示,老年面部皮肤肿瘤患者术后切口感染的独立危险因素为吸烟、糖尿病、手术部位为鼻部、面颊部和耳部、皮瓣手术、术后未使用抗生素以及术后未进行康复教育及护理。根据危险因素,成功构建列线图预测模型。列线图预测模型的C-index为0.811,ROC曲线下面积为0.811。校准曲线表明列线图校准良好,DCA曲线表明列线图模型具有良好的临床应用能力。结论吸烟、糖尿病、手术部位、手术类型、术后未使用抗生素以及术后未进行康复教育及护理是老年面部皮肤肿瘤患者术后切口感染的独立危险因素。基于这些因素构建的临床预测模型稳定性好,并具有一定的预测效能。Objective To establish a nomogram prediction model for the risk of postoperative incision infection in elderly patients with facial skin tumors and verify its predictive ability.Methods The medical records of 447 elderly patients who underwent skin tumor resection in our hospital from January 2018 to December 2021 were collected by retrospective analysis.According to the diagnostic criteria,they were divided into infection group(31 patients)and non-infection group(416 patients).Univariate analysis and multivariate logistic regression analysis were used to determine the independent risk factors for postoperative infection,and a nomogram containing these factors was established.The internal validation was performed by Bootstrap sampling method,and the predictive ability of the model was evaluated by consistency index(C-index),receiver operating characteristic curve(ROC curve),calibration curve and decision curve(DCA curve).Results The incidence of postoperative incision infection in 447 patients was 6.94%.Univariate analysis showed that there were significant differences in smoking history,diabetes history,surgical site,surgical type,postoperative antibiotic use,postoperative rehabilitation education and nursing between the two groups(P<0.05).Logistic regression analysis showed that the independent risk factors for postoperative incision infection in elderly patients with facial skin tumors were smoking,diabetes,surgical sites of nose,cheek and ear,flap surgery,no use of antibiotics after surgery,and no rehabilitation education and nursing after surgery.According to the risk factors,the nomogram prediction model was successfully constructed.The C-index of the nomogram prediction model was 0.811,and the area under the ROC curve was 0.811.The calibration curve showed that the nomogram was well calibrated,and the DCA curve showed that the nomogram model had good clinical application ability.Conclusion Smoking,diabetes,surgical site,type of operation,no use of antibiotics after operation and no rehabilitation education

关 键 词：面部皮肤肿瘤 切口感染 列线图 预测模型 

分 类 号：R739.5[医药卫生—肿瘤]