Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study.
Risk factors and predictive model for abdominal wound dehiscence in neonates: a retrospective cohort study.
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新生儿腹部伤口裂开的危险因素和预测模型：回顾性队列研究
DOI：
10.1080/07853890.2021.1938661
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发表时间：
2021-12
影响因子：
4.4
通讯作者：
Li J
中科院分区：
文献类型：
--
作者：
Duan S;Zhang X;Jiang X;Ou W;Fu M;Chen K;Xie X;Xiao W;Zheng L;Ma S;Li J
摘要背景腹部创伤裂开(AWD)是腹部外科的主要并发症，新生儿是AWD的高危人群，其后果严重，甚至可导致死亡。本研究的目的是探讨新生儿AWD的危险因素，并构建预测模型。方法回顾分析2009年6月至2020年6月453例新生儿剖腹手术的临床资料，其中确诊AWD 27例。分析性别、入院年龄、入院体重、早产、术前贫血程度、低蛋白血症、手术时间、切口长度、切口类型等9个因素与新生儿AWD的关系。结果新生儿AWD发生率为6.0%(27/453)，其中创面部分裂开占4.9%(22/453)，完全性裂开占1.1%(5/453)。在多因素模型中，低蛋白血症和切口类型是新生儿AWD的独立危险因素，入院时体重是AWD的保护因素。将这些因素综合在一起，构建了诺模图，并绘制了校正曲线。结果表明，当预测风险率大于35%左右时，实际风险接近预测风险。结论新生儿AWD与低蛋白血症、伤口污染密切相关。我们的预测模型显示了为接受腹部手术的新生儿患者提供AWD个体化风险评估的潜力。新生儿腹部伤口裂开(AWD)后果严重，新生儿AWD发生率约为6.0%，完全性AWD发生率为1.1%。低蛋白血症和切口类型是新生儿AWD的独立危险因素。我们的预测模型显示了为接受腹部手术的新生儿患者提供AWD个体化风险评估的潜力。
Abstract Background Abdominal wound dehiscence (AWD) is a major complication of abdominal surgery, and neonates are a group with a high risk of AWD, which has serious consequences or can even result in death. The purpose of this study is to explore the risk factors for neonatal AWD and construct a predictive model. Methods The clinical data of 453 cases that underwent neonatal laparotomy from June 2009 to June 2020 were retrospectively analyzed, among which 27 cases of AWD were identified. Nine factors, including gender, age at admission, weight at admission, preterm delivery, level of preoperative anaemia, hypoalbuminemia, operation time, incision length, and incision type, were analyzed to explore their correlation with neonatal AWD. Results The incidence of neonatal AWD was 6.0% (27/453), among which partial wound dehiscence accounted for 4.9% (22/453) and complete wound dehiscence accounted for 1.1% (5/453). Hypoproteinemia and incision type were the independent risk factors for neonatal AWD, and weight at admission was a protective factor for AWD in the multivariate models. All these factors were incorporated to construct a nomogram, and a calibration curve was plotted. The result indicated that the actual risk was close to the predicted risk when the predicted risk rate was greater than about 35%. Conclusions Neonatal AWD is closely related to hypoproteinemia and incision contamination. Our predictive model showed the potential to provide an individualized risk estimate of AWD for neonatal patients undergoing abdominal surgery. Key messages Neonatal abdominal wound dehiscence (AWD) has a serious consequence and the incidence of neonatal AWD was about 6.0% and the complete AWD morbidity is 1.1%. Hypoproteinemia and incision type were the independent risk factors for neonatal AWD. Our predictive model showed the potential to provide an individualized risk estimate of AWD for neonatal patients undergoing abdominal surgery.
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影响因子：
2.3
作者：
Denys, Andreas;Monbailliu, Thomas;van Ramshorst, Gabrielle H.
通讯作者：
van Ramshorst, Gabrielle H.
影响因子：
1.6
作者：
Duan, Shou-Xing;Sun, Zong-Bo;Li, Jian-Hong
通讯作者：
Li, Jian-Hong
DOI：
10.1016/j.injury.2018.05.001
发表时间：
2018-08-01
影响因子：
2.5
作者：
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通讯作者：
Han, Seung-Beom
影响因子：
3.9
作者：
Jovanović G;Jakovljević DK;Lukić-Šarkanović M
通讯作者：
Lukić-Šarkanović M
影响因子：
3.6
作者：
Wang, Junbo;Zhao, Ming;Li, Yong
通讯作者：
Li, Yong