Risk factor prediction of surgical site infection complicating total hip arthroplasty and construction of Nomogram model

LIU Teng-fei; JIA Ting-ting; TIAN Long

doi:10.3969/j.issn.2095-252X.2025.05.007

Abstract：Objective To explore the risk factors affecting surgical site infection(SSI)complicating total hip arthroplasty(THA)and construct Nomogram prediction model for infection risk.Methods A total of 15 000 patients who underwent THA surgery in the British National Hip Fracture Database from March 2021 to March 2024 were selected.According to SSI status,they were divided into non-infection and infection groups.Baseline data of the patients were collected.Logistic regression analysis was performed on them to identify the independent risk factors affecting SSI complicating THA.AUC and the best cut-off value were calculated through ROC curve.Nomogram prediction model was constructed by using the"rms"package in R language 4.0.Then predictive ability of the model was evaluated.Results Univariate difference analysis showed that age,proportion of hypertension,body mass index(BMI),proportion of general anesthesia,and proportion of patient-controlled intravenous analgesia(PCIA)in non-infection group were lower than those in infection group(all P<0.05).The serum albumin level in non-infection group was higher than that in infection group(P<0.05).Multivariate logistic regression analysis showed that advanced age(OR:1.168,95%CI:1.034-3.546),hypertension(OR:1.998,95%CI:1.176-6.289),high BMI(OR:1.654,95%CI:1.254-3.984),low serum albumin level(OR:1.758,95%CI:1.093-3.421),general anesthesia(OR:1.906,95%CI:1.105-5.483),PCIA(OR:1.667,95%CI:1.145-4.975)were all the independent risk factors for SSI complicating THA(all P<0.05).ROC curve results showed that AUC of Nomogram for predicting the risk of SSI complicating THA was 0.853(95%CI:0.662-0.904),which was higher than other predictive factors.The calibration curve of Nomogram prediction model showed good consistency,and the decision curve demonstrated that it could provide clinical net benefits.Conclusions Nomogram model for predicting SSI risk complicating THA has good predictive ability.It provides a certain theoretical reference for the prevention and treatment of this complication.