摘要
Abstract
Objective To construct and validate a risk prediction model for vascular crisis after finger replantation surgery,and to provide a reference basis for clinical early identification of patients at high risk of vascular crisis,formulation of personalized prevention strategies,and optimization of postoperative management procedures.Methods A total of 150 patients who underwent finger replantation surgery at Zhengzhou Second People's Hospital from January 2022 to January 2025 were selected as the research subjects.Among them,100 cases were in the modeling group and 50 cases were in the validation group.Multivariate Logistic regression analysis was used to screen the risk factors for vascular crisis,construct the prediction model,and evaluate the model performance through the area under the receiver operating characteristic curve(ROC),Youden index,sensitivity,specificity,and Hosmer-Lemeshow test.Results Among the 100 patients in the modeling group,the incidence of vascular crisis after finger replantation surgery was 16.00%.Univariate analysis showed that smoking history,degree of amputation,warm ischemia time,serum MDA and heparin anticoagulation factors were significantly different between the two groups(P<0.05).Multivariate Logistic regression analysis showed that smoking history(OR=3.72,95%CI 1.61-8.59,P=0.002),complete amputation(OR=3.01,95%CI 1.29-7.00,P=0.010),warm ischemia time≥4 hours(OR=3.45,95%CI 1.53-7.79,P=0.003),serum MDA≥5.0 nmol/mL(OR=3.28,95%CI 1.42-7.58,P=0.005),heparin anticoagulation(OR=0.33,95%CI 0.15-0.73,P=0.007)were independent risk factors;Based on these factors,a risk prediction model was constructed,and its ROC curve area was 0.938,sensitivity was 87.50%,and specificity was 93.10%.Conclusions Smoking history,degree of amputation,warm ischemia time,serum MDA,and heparin anticoagulation are independent risk factors for vascular crisis after finger replantation surgery.The constructed risk prediction model has good predictive ability and is helpful for clinical early identification of high-risk patients and taking targeted intervention measures.关键词
断指再植术/血管危象/预测模型/风险评分Key words
finger replantation surgery/vascular crisis/prediction model/risk score
