Analysis of risk factors for wound infection in animal injury patients and establishment of predictive models
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摘要: 目的 分析动物致伤患者伤口感染的危险因素，并构建预测模型。 方法 回顾性收集2020年10月—2022年12月收治的649例动物致伤患者临床资料，根据患者是否发生创面感染分为感染组和未感染组，分析动物致伤患者伤口感染的影响因素，并构建回归方程，采用受试者工作特征曲线(ROC)分析回归方程的预测价值。 结果 年龄≥51.5岁、受伤至清创时间≥6.5 h、受伤部位为手足、糖尿病是动物致伤患者伤口感染的独立危险因素，根据多因素分析结果构建回归方程及预测概率绘制ROC曲线，当Logit(P)>0.2043时，AUC为0.930(95%CI：0.897~0.964)，约登指数为0.759，灵敏度为86.0%，特异度为89.9%。 结论 动物致伤患者伤口感染的独立危险因素包括年龄≥51.5岁、受伤至清创时间≥6.5 h、受伤部位为手足、糖尿病，相关回归方程对动物致伤患者伤口感染的预测价值较好，为动物致伤患者伤口感染高危因素进行个体化评估治疗提供了依据。Abstract: Objective To analyze the risk factors of wound infection in patients with animal injuries and to establish a predictive model. Methods The clinical data of 649 patients with animal-injury from October 2020 to December 2022 were retrospectively collected. The patients were divided into infection group(n=86) and non-infection group(n=563) based on whether they experienced wound infection. The influencing factors of wound infection in patients with animal injury were analyzed, and the regression equation was constructed. The predictive value of the regression equation was analyzed by receiver operating characteristic(ROC) curve. Results Age≥ 51.5 years old, time from injury to debridement ≥6.5 hours, hand and foot injuries, and diabetes were independent risk factors for wound infection in patients with animal injuries. Regression equations were constructed based on the results of multivariate analysis and ROC curves were drawn with prediction probability. When Logit(P)>0.2043, AUC was 0.930(95%CI: 0.897-0.964), Youden index was 0.759, sensitivity was 86.0%, and specificity was 89.9%. Conclusion The independent risk factors of wound infection in animal injured patients include age ≥ 51.5 years old, time from injury to debridement ≥ 6.5 hours, injured parts are hands and feet, and diabetes. The correlation regression equation has a good predictive value for wound infection in animal injured patients, providing a basis for individualized evaluation and treatment of high-risk factors of wound infection in animal injured patients.
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Key words:
- animal injury /
- wound infection /
- risk factors /
- predictive models
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表 1 动物致伤患者伤口感染的单因素分析
因素 未感染组(563例) 感染组(86例) 统计量 P 年龄/岁 27.95±15.47 49.65±20.52 -9.407 ＜0.001 性别/例 0.047 0.829 男 281 44 女 282 42 致伤动物类别/例 9.732 0.204 狗 305 43 猫 205 31 鼠 37 7 蛇 5 2 蜂 8 1 蚁 2 1 猪 1 1 其他 1 0 受伤到清创时间/h 5.20±4.07 12.17±8.02 -7.911 ＜0.001 伤口类型/例 1.089 0.297 穿刺伤 159 29 撕裂伤 404 57 受伤部位/例 45.435 ＜0.001 手足 188 61 肢体 189 13 躯干 118 10 头面 68 2 是否扩创引流/例 0.174 0.677 是 82 14 否 481 72 糖尿病/例 140.880 ＜0.001 是 23 38 否 540 48 抗生素使用/例 2.178 0.140 是 25 7 否 538 79 是否豢养/例 0.213 0.644 是 457 68 否 106 18 
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表 2 动物致伤患者伤口感染的多因素分析logistic回归分析
因素 β SE Wald χ2 P 统计量 95%CI 年龄(是否≥51.5岁) 2.365 0.495 22.853 ＜0.001 10.648 4.037~28.082 受伤到清创时间(是否≥6.5h) 3.851 0.516 55.745 ＜0.001 47.051 17.120~129.311 受伤部位 14.908 0.002 肢体 -1.280 0.427 8.978 0.003 0.278 0.120~0.642 躯干 -1.188 0.469 6.425 0.011 0.305 0.122~0.764 头面 -1.935 0.884 4.786 0.029 0.144 0.026~0.818 是否糖尿病 1.547 0.591 6.859 0.009 4.696 1.476~14.945 注：表中“受伤部位”的多因素分析中设置哑变量进行分析，以受伤部位为“手足”作为参照，分析受伤部位为“肢体、躯干、头面”相对于受伤部位为“手足”的感染风险程度。
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