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Investigation of the occurrence of pressure ulcer during anesthetic surgery in elderly patients and establishment of prediction model |
SONG Huimin, YANG Yuling, MU Li, KANG Ni, LI Linji |
Department of Anesthesiology and Operating Room,Nanchong Central Hospital,the Second Clinical Medical School of North Sichuan Medical College, Nanchong 637000, China |
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Abstract Objective To investigate the occurrence of pressure ulcer in elderly patients during anesthetic surgery, and to establish a nomogram model to predict the risk and conduct internal verification. Methods A total of 327 elderly patients who underwent anesthetic surgery in Nanchong Central Hospital from February 2018 to August 2020 were selected for retrospective analysis. The factors that might cause pressure ulcer during anesthetic surgery were collected, and the patients were divided into two groups according to whether or not there was pressure ulcer. The differences were compared, and the influencing factors of pressure ulcer were analyzed by multi-factor Logistic regression, and a nomogram prediction model was established for internal verification. Results The skin condition of 327 cases was observed. During the observation period, 41 cases (12.53%) suffered from pressure ulcer. Nine potential influencing factors were screened by LASSO regression model, and multi-factor Logistic regression analysis showed that age, body mass index (BMI), smoking history, special posture during operation, changing posture during operation, operation time, temperature during operation, and albumin level were the independent influencing factors for the occurrence of pressure ulcer during anesthetic surgery in elderly patients (P<0.05). The ROC curve showed that the AUC of the model predicting pressure ulcer during anesthesia in elderly patients was 0.926 (95% CI: 0.888 to 0.965); the results of the calibration curve and the H-L goodness-of-fit test showed that the difference between the probability predicted by the model of the column and the actual probability of the line graph was not statistically significant (P>0.05). Conclusions The incidence of pressure ulcer during anesthesia surgery in elderly patients is relatively high, which is mainly affected by the patient's age, BMI, smoking history and other factors. The nomograph model established according to the above factors is characterized by high accuracy and differentiation in predicting the occurrence of pressure ulcer during anesthesia surgery.
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Received: 19 November 2023
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