Wei Li1 , Jing Huang1 , Hua Li1 , Tingchun Gou1 , Ling Tang1 , Xuesu Dong1 and Chunmei Luo2*
*Correspondence: Chunmei Luo 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。
1 Department of Anesthesiology, Xinqiao Hospital, Army Medical University, Chongqing, P.R. China
2 Department of Orthopedics, Xinqiao Hospital, Army Medical University,83 Xinqiao Main Street, Shapingba District, Chongqing 400037, P.R. China
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Abstract
Objective To construct a model for predicting the risk of IAPI (Intraoperative acquired pressure injury) in the facial area of patients undergoing prone position surgery and to validate the predictive effectiveness of this model.
Methods We analyzed data from 970 patients who underwent prone position surgery at a tertiary general hospital in Chongqing, China, from January 2022 to October 2022. Using univariate analysis and logistic regression analysis, we identified risk factors for IAPI in the maxillofacial region of patients undergoing prone position surgery and constructed a nomogram prediction model using R software. On the basis of the selected predictive factors, a risk prediction model was constructed and evaluated using the concordance index (C-index) and the area under the curve (AUC). External validation was conducted to verify the model’s performance.
Results The incidence of IAPI in prone surgery patients was 17.8%. Multivariate logistic regression analysis revealed that BMI, history of diabetes, surgical duration, muscle relaxant dosage, history of allergies, and preoperative Braden score were the most important factors for the occurrence of intraoperative pressure injuries in the facial region of patients who underwent prone position surgery (P<0.05). The area under the ROC curve of the prediction model is 0.863, the maximum Youden index is 0.681, the optimal cutoff value is 0.214, the sensitivity is 0.815, the specificity is 0.866, and the accuracy in actual application is 91.1%.
Conclusions The IAPI risk prediction model for maxillofacial surgery patients in the prone position constructed in this study demonstrated good predictive performance, providing a basis for clinical medical staff to quickly identify high risk patients and implement precise intervention plans before surgery.
Keywords Pressure ulcer, Prone position, Maxillofacial, Nomogram, Prediction model
Xiaolong Yu1 · Jing Xi1 · Jiabiao Wu2 · Ruixiao Song1
Received: 24 November 2024 / Revised: 18 January 2025 / Accepted: 16 February 2025 / Published online: 5 March 2025
© The Author(s) 2025
* Ruixiao Song 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。
1 Department of Ultrasonics, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
2 Rheumatology and Immunology Department, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China
Background Early cardiac damage is very common in RA patients, but it is usually subclinical. Therefore, finding a non invasive method for the early detection and treatment of cardiac damage in autoimmune diseases is particularly important.
Objective To evaluate left ventricular function changes in rheumatoid arthritis (RA) patients with preserved left ventricular ejection fraction (LVEF) using left ventricular pressure-strain loop (LV-PSL) technology and to explore the correlation between myocardial work (MW) and disease activity.
Methods A total of 62 RA patients with preserved LVEF, treated at Wujin Hospital Affiliated with Jiangsu University from January 2021 to September 2023, were included. Patients were categorized into low (25), medium (18), and high (19) disease activity groups based on the 28 joint disease activity score (DAS28). A control group of 29 healthy individuals was also established. LV-PSL technology assessed left ventricular global longitudinal strain (GLS) and MW parameters: global constructive work (GCW), global wasted work (GWW), global work index (GWI), and global work efficiency (GWE). Cor relations between MW parameters, GLS, LVEF, and DAS28 scores were analyzed.
Results There were no significant differences in general data between study and control groups (p>0.05). However, labora tory indicators (RF, CRP, ESR) showed significant differences (p<0.05). GWI, GCW, GWE, and GLS were significantly lower in the high disease activity group compared to controls (p<0.05). GWI, GCW, and GWE were positively correlated with LVEF and absolute GLS, while GWW correlated negatively with LVEF (p<0.05).
Conclusion RA disease activity is closely associated with impaired myocardial work. LV-PSL technology effectively moni tors myocardial function abnormalities in RA patients, providing valuable insights for clinical management.
Key PointsMyocardial work is significantly impaired in RA patients with high disease activity. Left ventricular pressure-strain loop (LV-PSL) technology effectively assesses cardiac function in this patient population. Increased disease activity correlates with reduced myocardial work parameters.
Keywords Left ventricular pressure-strain loop · Myocardial work · Rheumatoid arthritis · Speckle-tracking echocardiography
擅长:脊柱外科、脊柱微创技术、显微创伤外科、腰椎间盘突出症脊柱侧弯等。
熟练掌握了骨科常见病、多发病及疑难病症的诊治技术,成功抢救了各种多发伤、多发骨折等急诊、危重病人。能够熟练应用各种新型内固定材料手术治疗四肢及关节复杂骨折、复杂骨盆及髋臼骨折、骨不连等,手外伤的急诊手术、关节置换及翻修术、关节镜下手术,以及骨肿瘤、脊柱手术等各类骨科手术、手术治疗效果良好。能够熟练应用DHS、DCS、PFNA、髋动力锁定钢板、各种交锁髓内钉、解剖钢板及Liss钢板治疗四肢及关节复杂骨折、复杂骨盆及髋臼骨折手术、骨不连手术及手外伤的急诊手术、关节置换及翻修术、膝关节镜下半月板切除及交叉韧带重建术,以及骨肿瘤、脊柱手术等各类骨科手术、对创伤骨科微创治疗具有丰富的临床经验。
临床工作经验丰富,具有极为熟练的外科技能,在骨科各领域有较深的造诣。尤其在关节外科方面,已开展全身六大关节的关节镜检查和镜下手术,总体水平在广东领先,率先在广东开展关节镜下膝关节前、后交叉韧带重建术、膝关节半月板修补术、关节内骨折关节镜监视下复位固定术等高难度手术。并已开展四肢大关节的人工关节置换术,被广东省定为人工关节置换术指导专家。在复杂关节畸形的人工关节置换方面颇有研究。
擅长:危重烧伤救治/重度吸入性损伤的救治/小儿重度烧伤救治/严重皮肤撕脱伤及复合伤救治/烧伤瘢痕整复及功能重建/糖尿病足保肢治疗。
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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