Establishment and validation of Nomogram prediction model of intraoperative pressure injury in patients undergoing liver transplantation
10.3760/cma.j.cn115682-20220109-00114
- VernacularTitle:肝移植手术患者术中压力性损伤Nomogram预测模型的构建及验证
- Author:
Qi SUN
1
;
Xiaoran ZHANG
;
Yao DONG
Author Information
1. 首都医科大学附属北京朝阳医院手术室，北京 100021
- Keywords:
Operating Room nursing;
Liver transplantation;
Pressure injury;
Risk factors;
Nomogram prediction model
- From:
Chinese Journal of Modern Nursing
2022;28(36):5057-5062
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a Nomogram model for predicting intraoperative pressure injury in adult patients undergoing allograft orthotopic liver transplantation and to test its effectiveness.Methods:Using the convenient sampling method, a total of 257 patients who underwent allograft orthotopic liver transplantation in Beijing Chaoyang Hospital Affiliated to Capital Medical University from May 2015 to May 2021 were selected as the research objects for retrospective analysis. Multivariate Logistic regression was used to analyze the risk factors of intraoperative pressure injury in liver transplantation patients and a Nomogram model was established. The receiver operating characteristic (ROC) curve was used to verify the accuracy of the model.Results:Among the 257 patients, 39 had intraoperative pressure injury, with an incidence of 15.18% (39/257). Univariate analysis showed that high body mass index, low serum albumin before surgery, use of norepinephrine, epinephrine, large amount of blood loss and blood transfusion, intraoperative compression site immersion, long operation time and high score of end-stage liver disease model were risk factors for intraoperative pressure injury in patients undergoing liver transplantation ( P<0.05). Multivariate Logistic regression analysis showed that low level of preoperative serum albumin, norepinephrine use, intraoperative compression site immersion, long operation time and end-stage liver disease model score greater than 16 points were independent risk factors for intraoperative stress injury in transplant patients ( P<0.05). Based on this, the Nomogram model was established. The C- index value was 0.882, the area under ROC curve was 0.882 and the sensitivity and specificity were respectively 0.839 and 0.821. Conclusions:This Nomogram model established in this study can accurately predict the risk of intraoperative pressure injury in patients undergoing liver transplantation. This prediction method is convenient and intuitive, which can guide clinical nurses to quickly, effectively and accurately judge the risk of intraoperative stress injury in patients undergoing liver transplantation.
