Influencing factors and countermeasures for intraoperative acute pressure ulcer development in patients undergoing radical gastrointestinal tumor resection
Guo Chunxiao
Ni Weihui
Li Na
Su Xiaomei
Li Yuan
Sha Sha
Zhang Li
Wu Ying
Abstract：Objective To identify the factors influencing intraoperative acute pressure ulcer(APU)development in patients undergoing radical resection for gastrointestinal tumors,and to propose countermeasures for clinical decision-making.Methods Between April 2023 and October 2024,402 patients for radical gastrointestinal tumor resection at a hospital in Xinjiang were enrolled and divided into an APU group(n=30)and a non-APU group(n=372)based on the presence or absence of intraoperative APU occurrence.Multiva-riate logistic regression with stepwise selection was used to identify independent risk factors.A nomogram was constructed,and its predictive value for intraoperative APU in these patients was evaluated.Results Compared with the non-APU group,the APU group had higher proportions of patients aged≥60 years,those combined with diabetes,tumors≥2 cm in diameter,intraop-erative hypothermia,and intraoperative hypoxemia;they also had longer time of operations,higher body mass index(BMI),and lower hemoglobin and albumin levels,with statistical significance(P<0.05).Multivariate analysis identified age≥60 years(OR=2.088,95%CI:1.473-2.959),combined diabetes(OR=1.978,95%CI:1.423-2.749),longer time of op-eration(OR=2.601,95%CI:1.639-3.996),intraoperative hypothermia(OR=2.326,95%CI:1.590-3.402),and higher albumin level(OR=0.367,95%CI:0.237-0.568)as independent predictors of intraoperative APU during the radi-cal gastrointestinal tumor resection(P<0.05).The nomogram showed a C-index of 0.882(95%CI:0.829-0.935);good-ness of fit test yielded the following results:χ2=7.852,P=0.476;and a calibration slope close to 1.The nomogram model predicted the area under the curve(AUC)of intraoperative APU in patients undergoing the surgery to be 0.874(0.821-0.927),with a specificity of 67.59%and a sensitivity of 92.18%.Conclusion Age,combined diabetes status,time of opera-tion,intraoperative hypothermia,and albumin level are key factors influencing intraoperative APU development in patients un-dergoing radical gastrointestinal tumor resection.A nomogram based on these factors demonstrates high predictive accuracy.
Keywords：Radical gastrointestinal tumor resectionIntraoperative acute pressure ulcerInfluencing factorsNomogram model
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 87-93 )