Risk factors and prediction model construction for post-debridement infection in open wounds
Fang Ling
Luo Baoguang
You Xiaojun
Li Jiaxiu
Wang Na
Niu Xuerui
He Juren
Wu Shangshang
Abstract：Objective To identify risk factors for post-debridement infection in open wounds and construct a corresponding prediction model.Methods A total of 204 patients undergoing open wound debridement at North China Medical Group Xingtai General Hospital(July 2021-June 2024)were enrolled and assigned to infection(n=30)and non-infection(n=174)groups based on postoperative infection status.Multivariate logistic regression was used to analyze infection risk fac-tors,and a nomogram prediction model was developed.Receiver operating characteristic(ROC)curves were employed to e-valuate the model's predictive performance.Results The postoperative infection rate was 14.71%(30/204).No significant differences were noted in sex distribution,body mass index(BMI),smoking status,hypertension comorbidity,fracture site,surgical timing,time of operation,intraoperative blood loss,debridement frequency,white blood cell count,platelet count,prothrombin time(PT),or activated partial thromboplastin time(APTT)between groups(P>0.05).The infec-tion group had significantly higher proportions of age≥60 years,diabetes comorbidity,Gustilo type Ⅲ classification,wound depth≥2 cm,inadequate debridement,residual dead space,and non-prophylactic antibiotic use,along with longer injury-to-admission time,lower hemoglobin and albumin levels compared to the non-infection group(P<0.05).Multivari-ate regression identified age≥60 years,diabetes comorbidity,Gustilo type Ⅲ,inadequate debridement,and residual dead space as independent risk factors,while albumin level over 33.93 g/L was a protective factor(P<0.05).The nomogram model based on influence factors for predicting infection after open wound debridement resulted in a concordance index(C-in-dex)of 0.804(95%CI:0.752-0.856).The nomogram model predicted infection following open wound debridement with an area under the curve(AUC)of 0.864(95%CI:0.812-0.916),a specificity of 68.13%,and a sensitivity of 92.74%.Conclusion Key risk factors for post-debridement infection include advanced age,diabetes comorbidity,Gustilo type Ⅲ,in-adequate debridement,and residual dead space,with albumin≥33.93 g/L as a protective factor.The nomogram model based on these factors provides high predictive accuracy for predicting infection after open wound debridement and enables targeted interventions to reduce postoperative infection for high-risk patients.
Keywords：Open woundsDebridementInfectionRisk factorsNomogramPrediction model
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 125-130,147 )