摘要
目的分析全膝关节置换患者围手术期感染的危险因素,构建并验证列线图预测模型。方法回顾性分析2018年5月至2023年5月在盐城市第三人民医院完成全膝关节置换术治疗的540例患者的病历资料,根据围手术期是否发生感染将其分为观察组和对照组。收集两组患者的一般资料,对全膝关节置换患者围手术期感染进行单因素及多因素分析,构建并验证全膝关节置换患者围手术期感染列线图预测模型。结果540例患者中有16例患者围手术期发生感染,发生率为2.96%(16/540)。单因素分析表明,观察组患者疾病类型中的类风湿性关节炎占比、合并2型糖尿病占比、手术时间≥2 h占比、术后引流管留置时间>24 h占比均高于对照组,差异有统计学意义(P<0.05)。多因素分析表明,类风湿性关节炎、合并2型糖尿病、手术时间≥2 h是膝关节置换患者围手术期感染的危险因素(P<0.05)。绘制受试者操作特征(receiver operating characteristic,ROC)曲线,结果显示,曲线下面积(area under the curve,AUC)为0.806(95%CI:0.689~0.923)。校准曲线显示预测曲线与实际曲线一致性良好。Hosmer-Lemeshow检验结果表明模型拟合优度良好(χ^(2)=6.163,P=0.187)。结论类风湿性关节炎、合并2型糖尿病、手术时间≥2 h是全膝关节置换患者围手术期感染的危险因素,基于上述因素构建的列线图预测模型可用于全膝关节置换患者围手术期感染的预测,且有较高的预测效能。
Objective To analyze the risk factors for perioperative infection in patients undergoing total knee arthroplasty,and to construct and validate a column chart prediction model.Methods A retrospective analysis was conducted on the medical records of 540 patients who underwent total knee arthroplasty at Yancheng Third People's Hospital from May 2018 to May 2023.They were divided into observation group and control group based on whether infection occurred during the perioperative period.The general information of the two groups of patients were collected,univariate and multivariate analysis was performed on perioperative infection in patients with total knee arthroplasty,and the column chart prediction model of perioperative infection in patients with total knee replacement was constructed and verified.Results Among the 540 patients,16 patients developed infections during the perioperative period,with an incidence rate of 2.96%(16/540).The univariate analysis showed that the proportion of rheumatoid arthritis,the proportion of patients with type 2 diabetes,the proportion of patients with operation time≥2 h,and the proportion of patients with drainage tube retention time>24 h in the observation group were higher than those in the control group,with a statistical significant difference(P<0.05).Multivariate analysis showed that rheumatoid arthritis,type 2 diabetes,and operation time≥2 h were risk factors for perioperative infection in patients with knee arthroplasty(P<0.05).The receiver operating characteristic(ROC)curve was drawn,and the results showed that the area under the curve(AUC)was 0.806(95%CI:0.689-0.923).The calibration curve showed good consistency between the predicted curve and the actual curve.The Hosmer Lemeshow test results indicated that the model had good goodness of fit(χ^(2)=6.163,P=0.187).Conclusions Rheumatoid arthritis,type 2 diabetes,and operation time≥2 h are risk factors for perioperative infection in patients with total knee arthroplasty.The nomogram prediction model based on the above
作者
李晓青
朱小平
LI Xiao-qing;ZHU Xiao-ping(Department of Operation Room,Yancheng Third People’s Hospital,Yancheng,Jiangsu 224000,China;不详)
出处
《慢性病学杂志》
2024年第6期816-820,共5页
Chronic Pathematology Journal
基金
江苏省卫生健康委课题(202203034)
关键词
全膝关节置换
围手术期感染
列线图预测模型
Perioperative infection
Total knee arthroplasty
Nomogram prediction model
