Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery
Objectives: This study aimed to develop a nomogram for predicting the risk of pressure injury (PI) in adult patients undergoing abdominal surgery and validate its effectiveness among these patients. Methods: This study retrospectively included 11,247 adult patients, who underwent abdominal surgery a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | International Journal of Nursing Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S235201322200076X |
| _version_ | 1811250856915369984 |
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| author | Xue Feng Meng Wang Ya Zhang Qian Liu Mingyang Guo Hongyin Liang |
| author_facet | Xue Feng Meng Wang Ya Zhang Qian Liu Mingyang Guo Hongyin Liang |
| author_sort | Xue Feng |
| collection | DOAJ |
| description | Objectives: This study aimed to develop a nomogram for predicting the risk of pressure injury (PI) in adult patients undergoing abdominal surgery and validate its effectiveness among these patients. Methods: This study retrospectively included 11,247 adult patients, who underwent abdominal surgery and postoperative supervision in ICU, in a tertiary care hospital in western China between January 2017 and December 2020. All datasets were extracted from the patient’s medical records and randomly divided into the training cohort (8,997) and the validation cohort (2,250) by 8:2. The univariable logistic regression was used to select potentially relevant features. Then, multivariable logistic regression was also conducted and utilized to establish the nomogram. The nomogram was compared with the Braden scale for predicting PI in the validation cohort through the area under the curve (AUC) of the receiver operator characteristic (ROC) curve, Hosmer-Lemeshow (H-L) test, and decision curve analysis (DCA). Results: 873 (7.8%) patients suffered PIs. Logistic regression analysis showed that time of operation, weight, type of operation, albumin, and Braden scale score were independent risk factors for PI. A nomogram integrating five selected characteristics was constructed. The AUC of the ROC curve for the nomogram was 0.831, with a specificity of 85.2% and sensitivity of 63.7%. The AUC of the ROC curve for the Braden scale was 0.567, with a specificity of only 33.0%. The P-values of the H-L test were 0.45 (nomogram) and 0.22 (Braden scale), both indicating good calibration. The DCA also displayed that the nomogram had better predictive validity. Conclusion: Compared with the Braden scale, the nomogram showed a better predictive performance. This nomogram is informative and has the potential to better guide caregivers for risk stratification and prevention of PI, although it requires further validation. |
| first_indexed | 2024-04-12T16:11:01Z |
| format | Article |
| id | doaj.art-5f8433a5a0584a2da3cce331b168231c |
| institution | Directory Open Access Journal |
| issn | 2352-0132 |
| language | English |
| last_indexed | 2024-04-12T16:11:01Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Nursing Sciences |
| spelling | doaj.art-5f8433a5a0584a2da3cce331b168231c2022-12-22T03:25:54ZengElsevierInternational Journal of Nursing Sciences2352-01322022-10-0194438444Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgeryXue Feng0Meng Wang1Ya Zhang2Qian Liu3Mingyang Guo4Hongyin Liang5Department of General Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, ChinaDepartment of Traditional Chinese Medicine, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, ChinaDepartment of Traditional Chinese Medicine, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, ChinaDepartment of Traditional Chinese Medicine, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, ChinaDepartment of Traditional Chinese Medicine, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, ChinaDepartment of General Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China; Corresponding author.Objectives: This study aimed to develop a nomogram for predicting the risk of pressure injury (PI) in adult patients undergoing abdominal surgery and validate its effectiveness among these patients. Methods: This study retrospectively included 11,247 adult patients, who underwent abdominal surgery and postoperative supervision in ICU, in a tertiary care hospital in western China between January 2017 and December 2020. All datasets were extracted from the patient’s medical records and randomly divided into the training cohort (8,997) and the validation cohort (2,250) by 8:2. The univariable logistic regression was used to select potentially relevant features. Then, multivariable logistic regression was also conducted and utilized to establish the nomogram. The nomogram was compared with the Braden scale for predicting PI in the validation cohort through the area under the curve (AUC) of the receiver operator characteristic (ROC) curve, Hosmer-Lemeshow (H-L) test, and decision curve analysis (DCA). Results: 873 (7.8%) patients suffered PIs. Logistic regression analysis showed that time of operation, weight, type of operation, albumin, and Braden scale score were independent risk factors for PI. A nomogram integrating five selected characteristics was constructed. The AUC of the ROC curve for the nomogram was 0.831, with a specificity of 85.2% and sensitivity of 63.7%. The AUC of the ROC curve for the Braden scale was 0.567, with a specificity of only 33.0%. The P-values of the H-L test were 0.45 (nomogram) and 0.22 (Braden scale), both indicating good calibration. The DCA also displayed that the nomogram had better predictive validity. Conclusion: Compared with the Braden scale, the nomogram showed a better predictive performance. This nomogram is informative and has the potential to better guide caregivers for risk stratification and prevention of PI, although it requires further validation.http://www.sciencedirect.com/science/article/pii/S235201322200076XAdultNomogramPatientsPressure ulcerSurgical procedures |
| spellingShingle | Xue Feng Meng Wang Ya Zhang Qian Liu Mingyang Guo Hongyin Liang Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery International Journal of Nursing Sciences Adult Nomogram Patients Pressure ulcer Surgical procedures |
| title | Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery |
| title_full | Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery |
| title_fullStr | Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery |
| title_full_unstemmed | Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery |
| title_short | Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery |
| title_sort | development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery |
| topic | Adult Nomogram Patients Pressure ulcer Surgical procedures |
| url | http://www.sciencedirect.com/science/article/pii/S235201322200076X |
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