摘要
Abstract
Objective:To construct an individualized nomogram model for predicting the risk of acute intraoperative pressure injury in gynecologic malignancies in the elderly,and to validate the predictive ability of the model.Methods:505 geriatric gynecologic malignant tumor patients who underwent surgical treatment in Jiangsu Provincial People's Hospital from June 2018 to June 2023 were selected,among which 51 cases of intraoperative acute pressure injury occurred(injury group).Risk factors for intraoperative acute stress injury in geriatric gyneco-logic malignant tumors were analyzed by univariate and multivariate logistic regression,and the related nomogram prediction model was established.Results:Tumor stage,preoperative Munro scale score,preoperative ALB,preoperative Hb,operation time,intraoperative bleeding and intr-aoperative temperature fluctuation were compared between patients in the injury group and non-injury group,and the differences were statistically significant(P<0.05).Multifactorial logistic regression analysis showed that stage Ⅲ～Ⅳ tumor,high preoperative Munro scale score,preop-erative ALB<35g/L,preoperative Hb<110g/L,operative time≥180min,and intraoperative bleeding volume≥500mL and intraoperative temperature fluctuation were independent risk fac-tors for intraoperative acute pressure injury in elderly patients with gynecologic malignancies(P<0.05).Nomogram model validation results:the C-index index was 0.809(95％CI:0.781～0.836),the Hosmer-Lemeshoe goodness-of-fit test showed a good model fit(x2=4.308,P=0.117),the AUC of the ROC curve was 0.811(95％CI:0.783～0.839),and the model ben-efit values were positive in the predictable range of 1％to 80％of the nomogram.Conclusions:Risk factors for the occurrence of intraoperative acute pressure injury in elderly patients with gy-necologic malignancies include stage Ⅲ～Ⅳ tumors,high preoperative Munro scale scores,pre-operative ALB<35g/L,preoperative Hb<110 g/L,operative time≥180min,and intraoperative bleeding≥500mL and intraoperative temperature fluctuation.The nomogram model constructed based on the above factors has a positive effect on the risk of intraoperative acute pressure inju-ry in elderly patients with gynecologic malignancies.The nomogram model based on the above factors has a high predictive value for the risk of acute stress injury in elderly patients with gy-necologic malignancies.关键词
老年妇科恶性肿瘤/术中急性压力性损伤/危险因素/Nomogram/模型验证Key words
Gynecologic malignancies in the elderly/Intraoperative acute pressure in-jury/Risk factors/Nomogram/Model validation分类
医药卫生
