Concurrent validation and reliability of digital image analysis of granulation tissue color for clinical pressure ulcers
Concurrent validation and reliability of digital image analysis of granulation tissue color for clinical pressure ulcers
复制标题
DOI：
10.1111/j.1524-475x.2011.00686.x
复制
发表时间：
2011-07-01
影响因子：
2.9
通讯作者：
Sanada, Hiromi
中科院分区：
文献类型：
--
作者：
Iizaka, Shinji;Sugama, Junko;Sanada, Hiromi
肉芽组织颜色是压疮（PU）评估的指标之一。然而，它只需要主观评价，并没有建立定量的方法。我们从数字图像分析中开发了颜色指标，并研究了它们在临床脓液中的有效性和可靠性。对47例55例全层脓肿进行横断面研究。经过颜色校准后，将伤口照片转换为三张表示红色的图像：红斑指数（EI）、经过额外颜色校准的修正红斑指数（肉芽红指数[GRI]）和(a) over cap*，其中(a)表示人工创建的L*a*b*颜色空间的红绿轴。计算肉芽组织区域的平均强度和超过最佳截止强度的像素百分比（%强度）。平均GRI （rho=0.39, p=0.007）和(a) over cap* (rho=0.55, p < 0.001)及其%强度指标与三刺激比色仪测量的a*呈正相关，而红斑指数与a*呈正相关。它们与伤口液中羟脯氨酸浓度、健康肉芽组织面积和血血红蛋白水平相关。同时使用GRI和*进行指标计算的组内信度和组间信度的组内相关系数> 0.9。数字图像分析的GRI和(a) over cap*可以定量评价临床脓液肉芽组织颜色。
Granulation tissue color is one indicator for pressure ulcer (PU) assessment. However, it entails a subjective evaluation only, and quantitative methods have not been established. We developed color indicators from digital image analysis and investigated their concurrent validity and reliability for clinical PUs. A cross-sectional study was conducted on 47 patients with 55 full-thickness PUs. After color calibration, a wound photograph was converted into three images representing red color: erythema index (EI), modified erythema index with additional color calibration (granulation red index [GRI]), and (a) over cap*, which represents the artificially created red-green axis of L*a*b* color space. The mean intensity of the granulation tissue region and the percentage of pixels exceeding the optimal cutoff intensity (% intensity) were calculated. Mean GRI (rho=0.39, p=0.007) and (a) over cap* (rho=0.55, p < 0.001), as well as their % intensity indicators, showed positive correlations with a* measured by tristimulus colorimeter, but erythema index did not. They were correlated with hydroxyproline concentration in wound fluid, healthy granulation tissue area, and blood hemoglobin level. Intra-and interrater reliability of the indicator calculation using both GRI and * had an intraclass correlation coefficient > 0.9. GRI and (a) over cap* from digital image analysis can quantitatively evaluate granulation tissue color of clinical PUs.