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BMC Surgery
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Research

Development of a nomogram to predict surgical site infection after closed comminuted calcaneal fracture

Authors: Jia-sen Hu, Cheng-bin Huang, Shu-ming Mao, Kang-hao Fang, Zong-yi Wu, You-ming Zhao

Published in: BMC Surgery | Issue 1/2022

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Abstract

Background

Compared with open comminuted calcaneal fractures, less emphasis is placed on postoperative surgical site infection (SSI) of closed comminuted calcaneal fractures. This study aimed to identify the risk factors associated with SSI and build a nomogram model to visualize the risk factors for postoperative SSI.

Methods

We retrospectively collected patients with closed comminuted calcaneal fractures from the Second Affiliated Hospital of Wenzhou Medical University database from 2017 to 2020. Risk factors were identified by logistics regression analysis, and the predictive value of risk factors was evaluated by ROC (receiver operating characteristic curve). Besides, the final risk factors were incorporated into R4.1.2 software to establish a visual nomogram prediction model.

Results

The high-fall injury, operative time, prealbumin, aspartate aminotransferase (AST), and cystatin-C were independent predictors of SSI in calcaneal fracture patients, with OR values of 5.565 (95%CI 2.220–13.951), 1.044 (95%CI 1.023–1.064), 0.988 (95%CI 0.980–0.995), 1.035 (95%CI 1.004–1.067) and 0.010 (95%CI 0.001–0.185) (Ps < 0.05). Furthermore, ROC curve analysis showed that the AUC values of high-fall injury, operation time, prealbumin, AST, cystatin-C, and their composite indicator for predicting SSI were 0.680 (95%CI 0.593–0.766), 0.756 (95%CI 0.672–939), 0.331 (95%CI 0.243–0.419), 0.605 (95%CI 0.512–0.698), 0.319 (95%CI 0.226–0.413) and 0.860 (95%CI 0.794–0.926), respectively (Ps < 0.05). Moreover, the accuracy of the nomogram to predict SSI risk was 0.860.

Conclusions

Our study findings suggest that clinicians should pay more attention to the preoperative prealbumin, AST, cystatin C, high-fall injury, and operative time for patients with closed comminuting calcaneal fractures to avoid the occurrence of postoperative SSI. Furthermore, our established nomogram to assess the risk of SSI in calcaneal fracture patients yielded good accuracy and can assist clinicians in taking appropriate measures to prevent SSI.
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Metadata
Title
Development of a nomogram to predict surgical site infection after closed comminuted calcaneal fracture
Authors
Jia-sen Hu
Cheng-bin Huang
Shu-ming Mao
Kang-hao Fang
Zong-yi Wu
You-ming Zhao
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01735-4

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