The use of a logistic regression model to develop a risk assessment of intraoperatively acquired pressure ulcer.

Abstract

To screen the factors of intraoperatively acquired pressure ulcer and establish a new risk assessment model of intraoperatively acquired pressure ulcer. This is a prospective study. A total of 1,963 patients who received neurosurgery, orthopaedics, paediatric surgery and cardiac surgery therapy in Sichuan Academy of Medical Science and Provincial People's Hospital in China from October 2015-October 2016 were enrolled in the study, and their clinical parameters were collected. Multivariable logistic regression analysis and decision tree analysis were used to analyse and screen the factors of intraoperatively acquired pressure ulcer and establish the risk assessment model of intraoperatively acquired pressure ulcer. The risk factors for intraoperatively acquired pressure ulcer included the application of external force during operation (β=1.10, OR=3.20), lean body mass (β=1.08, OR=2.95), time of operation ≥6hr (β=2.66, OR=14.30), prone position operation (β=1.13, OR=3.10), cardiopulmonary bypass during operation (β=1.72, OR=5.59) and intraoperative blood loss (β=0.67, OR=1.95). The new risk assessment model showed that the AUC of ROC curve was 0.897 (p<.001). According to the maximum principle of Youden's index, the sensitivity, specificity and Youden's index J of the model were 0.81, 0.88 and 0.69, respectively, when the cut-off point was set at π=0.025. A new and relatively reliable assessment model for intraoperatively acquired pressure ulcer is established. Pressure ulcers remain a challenge in clinical nursing. A new risk assessment model of pressure ulcers that is applicable to surgical patients is highly recommended.