A multicenter-based study on risk factor analysis and risk prediction model for necrotizing fasciitis
WEI Xinke
HAN Juntao
SUN Yaowen
ZHOU Haowei
MA Xinrui
LYU Weihao
SHAO Zhongjun
LI Jing
Abstract：Objective To analyze the independent risk factors for necrotizing fasciitis(NF)through multi-center clinical study,and then construct a risk prediction model for NF and validate it.Methods A case-control study was used to select NF patients admitted to the departments of burn surgery of Tangdu Hospital and Xijing Hospital of Air Force Medical University and Shaanxi Provincial People's Hospital from January 2008 to August 2023 as case group(NF group),and patients with common soft tissue infections as control group(non-NF group)based on the inclusion and exclusion criteria.The patients of the two groups were randomly divided into training set and validation set according to the ratio of 7∶3.The clinical data of the patients were collected,the variables that were statistically different between the two groups were screened by logistic univariate analysis,and the least absolute shrinkage and selection operator regression was performed on the above differential variables to derive the independent risk factors for NF.Based on the independent risk factors,a risk prediction model for NF was constructed,the nomogram was plotted,and the model was validated.Results A total of 159 NF patients and 346 patients with common soft tissue infections were collected.Statistical analysis showed that different disease sites,high body temperature,high blood glucose at admission,lowered red blood cell count and albumin,and elevated C-reactive protein(CRP),D-dimer,and fibrinogen degradation product(FDP)were independent risk factors for NF(P＜0.05).The area under the receiver operating characteristic curve for the training set model to diagnose NF was 0.888,and that for the validation set was 0.892,suggesting that the model has good diagnostic ability.In the calibration assessment,the curves of both models were close to the ideal curve,suggesting that the model has good calibration.Finally,a nomogram was drawn to assess the probability of patients developing NF.Conclusion Different disease sites,high body temperature,high blood glucose at admission,lowered red blood cell count and albumin,and elevated CRP,D-dimer,and FDP are independent risk factors for NF.The risk prediction model constructed accordingly has good auxiliary diagnostic performance and can provide an important reference basis for early diagnosis of NF.
Keywords：necrotizing fasciitisrisk factorsearly diagnosisrisk prediction modelcase-control study
Publication Date：2025-08-31
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：7( 1037-1042,1046 )