ICU体外循环术后患者压力性损伤列线图预测模型构建与验证

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Abstract Objective To develop and validate a nomogram model for predicting pressure injury in critically ill patients after cardiopulmonary bypass,which provides a theoretical basis for selecting a pressure injury prediction tool suitable for patients after ICU cardiopulmonary bypass. Methods A total of 268 patients after cardiopulmonary bypass admitted to ICU of a general hospital from January 2021 to December 2021 were eligible for the candidates of this study. General data,treatment parameters,laboratory results and other data were collected from the electric hospital information system. The logsitic regression analysis was performed to detect the risk factors and to develop a nomogram prediction model. The area under receiver operating characteristic curve,calibration curve and decision curve were used to evaluate the prediction ability of the model. Results 1）108 patients developed pressure injury in ICU,the incidence of ICU,acquired pressure injury was approximately 40.29%.2）In logistic regression analysis,vasopressor inotropic score（OR=1.246）,duration of cardiopulmonary bypass（OR=1.015）,APACHEII（OR=1.142）and IL-6（OR=1.003）were identified as risk factors of pressure injury.3）The area under the curve of the model was 0.865,and the sensitivity and specificity were 0.907 and 0.780,respectively. The concordance index of the model was 0.916. Hosmer,lemeshow test：χ²=6.363, P=0.607. The calibration curve showed that it had a good consistency between the observed and actual probability. Conclusion The nomogram model has good predictive efficacy for pressure injury in ICU patients after cardiopulmonary bypass,which is helpful to identify patients with high risk of pressure injury.

Key words： critical care cardiopulmonary bypass pressure injury nomogram

Received: 12 September 2022

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R642

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	DONG Zhenghui
	LI Zhengang
	WANG Yating
	QI Jinfang

Cite this article:

DONG Zhenghui,LI Zhengang,WANG Yating等. Development and validation of a prediction model of pressure injury in critically ill patients after cardiopulmonary bypass[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(6): 127-131.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I6/127

[1] GAO L,YANG L,LI X,et al.The use of a logistic regression model to develop a risk assessment of intraoperatively acquired pressure ulcer[J]. J Clin Nurs,2018,27(16):2984-2992.
[2] HATANAKA N,YAMAMOTO Y,ICHIHARA K,et al.A new predictive indicator for development of pressure ulcers in bedridden patients based on common laboratory tests results[J]. J Clin Pathol,2008,61(4):514-518.
[3] LIU F,LI L,XU M,et al.Prognostic value of interleukin,6,C,reactive protein,and procalcitonin in patients with COVID-19[J]. J Clin Virol,2020,7(127):104370.
[4] BASILE-FILHO A,LAGO AF,MENEGUETI MG,et al.The use of APACHE II,SOFA,SAPS 3,C,reactive protein/albumin ratio,and lactate to predict mortality of surgical critically ill patients:A retrospective cohort study[J]. Medicine(Baltimore),2019,98(26):e16204.
[5] XU X,MA Y,YAO Z,et al.Prevalence and Risk Factors for Pressure Ulcers in Patients with Enterocutaneous Fistula:A Retrospective Single Center Study in China[J]. Med Sci Monit,2019,9(25):2591-2598.
[6] KUMTA N,COYER F,DAVID M.Perioperative factors and pressure ulcer development in postoperative ICU patients:a retrospective review[J]. J Wound Care,2018,27(8):475-485.
[7] SUN ZW,GUO MR,YANG LZ,et al.Risk Factor Analysis and Risk Prediction Model Construction of Pressure Injury in Critically Ill Patients with Cancer:A Retrospective Cohort Study in China[J]. Med Sci Monit,2020,19(26):e926669.
[8] CHEN X,LIAO H,GAO W,et al.Cardiopulmonary Bypass Duration and the Incidence of Pressure Injuries in Patients Undergoing Cardiovascular Surgery:A Retrospective Cohort Study[J]. J Wound Ostomy Continence Nurs,2020,47(4):343-348.
[9] LIU J,RYBAKINA EG,KORNEVA EA,et al.Effects of Derinat on ischemia reperfusion,induced pressure ulcer mouse model[J]. J Pharmacol Sci,2018,138(2):123-130.
[10] KIMURA N,NAKAGAMI G,MINEMATSU T,et al.Non-invasive detection of local tissue responses to predict pressure ulcer development in mouse models[J]. J Tissue Viability,2020,29(1):51-57.
[11] MERVIS JS,PHILLIPS TJ.Pressure ulcers:Pathophysiology,epidemiology,risk factors,and presentation[J]. J Am Acad Dermatol,2019,81(4):881-890.
[12] KUROSE T,HASHIMOTO M,OZAWA J,et al.Analysis of Gene Expression in Experimental Pressure Ulcers in the Rat with Special Reference to Inflammatory Cytokines[J]. PLoS One,2015,10(7):e0132622.
[13] PONS S,FODIL S,AZOULAY E,et al.The vascular endothelium:the cornerstone of organ dysfunction in severe SARS-CoV-2 infection[J]. Crit Care,2020,24(1):353.
[14] CHEN X,LIN J,LIANG Q,et al.Pseudoephedrine alleviates atopic dermatitis,like inflammatory responses in vivo and in vitro[J]. Life Sci,2020,10(258):118139.
[15] LIU J,RYBAKINA EG,KORNEVA EA,et al.Effects of Derinat on ischemia-reperfusion,induced pressure ulcer mouse model[J]. J Pharmacol Sci,2018,138(2):123-130.
[16] MIHARA M,MORIYA Y,OHSUGI Y.IL-6,soluble IL-6 receptor complex inhibits the proliferation of dermal fibroblasts[J]. Int J Immunopharmacol,1996,18(1):89-94.
[17] SUGAWARA T,GALLUCCI RM,SIMEONOVA PP,et al.Regulation and role of interleukin 6 in wounded human epithelial keratinocytes[J]. Cytokine,2001,15(6):328-336.
[18] RANUCCI M,BALLOTTA A,DI DEDDA U,et al.The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome[J]. J Thromb Haemost,2020,18(7):1747-1751.
[19] LIMA SERRANO M,GONZÁLEZ MÉNDEZ MI,CARRASCO CEBOLLERO FM,et al. Risk factors for pressure ulcer development in Intensive Care Units:A systematic review[J]. Med Intensiva,2017,41(6):339-346.
[20] COX J,ROCHE S.Vasopressors and development of pressure ulcers in adult critical care patients[J]. Am J Crit Care,2015,24(6):501-510.
[21] BELLETTI A,LEROSE CC,ZANGRILLO A,et al.Vasoactive Inotropic Score:Evolution,Clinical Utility,and Pitfalls[J]. J Cardiothorac Vasc Anesth,2021,35(10):3067-3077.
[22] 王欣然,韩斌如. 外科重症患者压疮发生高危因素分析[J]. 中国护理管理,2014,14(2):138-140.
[23] MEDINA-CONCEPCIÓN A,DEL CRISTO ACOSTA-RAMOS M,PÉREZ-GARCÍA I,et al. Effect of infused norepinephrine dosage on pressure ulcers in perianesthesia care unit patients:a pilot study[J]. J Perianesth Nurs,2011,26(1):25-34.
[24] MAGNIN M,AMSON H,VACHERON CH,et al.Associations between peripheral perfusion disorders,mean arterial pressure and dose of norepinephrine administrated in the early phase of septic shock[J]. Clin Exp Pharmacol Physiol,2021,48(10):1327-1335.
[25] RANZANI OT,SIMPSON ES,JAPIASSÚ AM,et al.The Challenge of Predicting Pressure Ulcers in Critically Ill Patients,A Multicenter Cohort Study[J]. Ann Am Thorac Soc,2016,13(10):1775-1783.
[26] 李振刚,王亚婷,祁进芳,等. 三种压力性损伤评估量表对ICU体外循环术后患者压力性损伤预测能力比较[J]. 中国医药导报,2022,19(9):50-54.
[27] 王亚婷,陈桂花,董正惠. Norton量表对ICU低温体外循环心脏外科术后患者压力性损伤的预测价值及护理策略[J]. 实用心脑肺血管病杂志,2019,27(3):99+103.