title: A new nomogram score for predicting surgery-related pressure ulcers in cardiovascular surgical patients.
abstract: The aim of this study was to build a new nomogram score for predicting surgery-related pressure ulcers (SRPU) in cardiovascular surgical patients. We performed a prospective cohort study among consecutive patients with cardiovascular surgery between January 2015 and December 2015. Univariate and multivariate logistic regression was used to analyse the risk factors for SRPU. A nomogram-predicting model was built based on the logistic regression model. Then, calibration and discrimination were tested. A total of 149 patients with cardiovascular surgery were included in the study. Thirty-seven patients developed SRPUs, with an incidence rate of 24·8% (95%CI: 18·1-32·6%). The logistic regression model for predicting SRPU with four risk factors was Logit(P) = (1·861 × VDH, OR 2·174 × CAD, OR 1·747 × TAA) - 0·029 × weight + 0·005 × surgery duration + 1·241 × perioperative corticosteroids administration (P = 0·003, R2= 0·1181). The goodness-of-fit test (Pearson χ2= 150·69, P = 0·217) indicated acceptable calibration, and the C-index (0·725) indicated moderate discrimination. When the probability cut-off is 0·25 (total score 12), the nomogram model has the best sensitivity and specificity in predicting SRPU. We established a new nomogram model that can provide an individual prediction of SRPU in cardiovascular surgical patients. When the probability is more than 0·25 (total score 12), the cardiovascular surgery patients should be considered at high-risk.
authors.affiliation: Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, PR China.
authors.forename: Cai-Xia
authors.initials: CX
authors.lastname: Lu
authors.affiliation: School of Nursing, Nantong University, Nantong, Jiangsu, PR China.
authors.forename: Hong-Lin
authors.initials: HL
authors.lastname: Chen
authors.affiliation: School of Nursing, Nantong University, Nantong, Jiangsu, PR China.
authors.forename: Wang-Qin
authors.initials: WQ
authors.lastname: Shen
authors.affiliation: Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, PR China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Feng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D011183:Postoperative Complications / Q000209:etiology*; D011237:Predictive Value of Tests; D003668:Pressure Ulcer / Q000209:etiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Calibration; Cardiovascular surgery; Discrimination; Nomogram score; Surgery-related pressure ulcer