糖尿病足溃疡复发风险预测模型的构建

Construction of risk prediction model for recurrence of diabetic foot ulcer

目的:探讨糖尿病足溃疡病人溃疡愈合后1年内疾病复发情况及影响因素,并构建风险预测模型。方法:采用便利抽样法选取2015年1月-2019年7月在成都市某三级甲等医院经住院治疗后溃疡愈合的糖尿病足溃疡病人作为研究对象,根据病人1年内糖尿病足溃疡复发情况将病人分为复发组和未复发组,利用单因素分析和Logistic回归分析探讨糖尿病足溃疡复发的影响因素,建立风险预测模型,通过受试者工作特征曲线下面积(AUC)及Hosmer-Lemeshow检验评估模型预测效果。结果:465例病人完成随访,随访完成率为89.1%,病人1年内糖尿病足溃疡复发率为26.9%。Logistic回归分析结果显示,吸烟、足部皮肤颜色异常、胼胝、糖尿病周围神经病变、冠心病为糖尿病足溃疡复发的影响因素,构建的预测模型为Z=-1.959+0.762X1+0.605X2+2.480X3+0.692X4+0.845X5,其中,X_(1)为吸烟,X_(2)为足部皮肤颜色异常,X_(3)为胼胝,X_(4)为糖尿病周围神经病变,X_(5)为冠心病,模型AUC为0.855,Hosemer-Lemeshow检验P=0.118。结论:吸烟、足部皮肤颜色异常、胼胝、糖尿病周围神经病变、冠心病为糖尿病足溃疡复发的影响因素,构建的预测模型具有良好的预测效果,可为医务人员及时识别并干预糖尿病足溃疡复发风险提供依据。

Objective:This study aimed to investigate the current status and influencing factors of diabetic foot ulcer recurrence within 1 year after healing and to establish a risk prediction model.Methods:The convenience sampling method was used to select patients with diabetic foot ulcers who had ulcers healed after hospitalization in a tertiary hospital in Chengdu from January 2015 to July 2019 as the research objects.The patients were divided into the recurrence group and the non-recurrence group according to the recurrence situation of diabetic foot ulcer within 1 year.Univariate analysis and Logistic regression analysis were used to explore the influencing factors of the recurrence of diabetic foot ulcers,and a risk prediction model was established.The area under the receiver operating characteristic curve(AUC)and Hosmer-Lemeshow test were used to evaluate predictive effect of the model.Results:A total of 465 patients completed follow-up,with a follow-up completion rate was 89.1%,and the recurrence rate of foot ulcer within one year was 26.9%.Logistic regression analysis showed that smoking,abnormal foot skin color,callus,diabetic peripheral neuropathy,coronary heart disease were independent influencing factors of recurrence of diabetic foot ulcer,and the prediction model constructed was Z=-1.959+0.762X1+0.605X2+2.480X3+0.692X4+0.845X5,in which X_(1) was smoking,X_(2) was abnormal foot skin color,X_(3) was callus,X_(4) was diabetic peripheral neuropathy,X_(5) was coronary heart disease.Model AUC was 0.855,and Hoseme-Lemeshow test P=0.118.Conclusions:Smoking,callus,abnormal foot skin color,diabetic peripheral neuropathy and coronary heart disease are influencing factors for foot ulcer recurrence.The established prediction model has a good prediction effect,which can provide a basis for medical personnel to identify and intervene in a timely manner in the risk of foot ulcer recurrence.