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A nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability

Surgical site infection (SSI) is a common and serious complication of transforaminal lumbar interbody fusion (TLIF), and the occurrence of SSI usually leads to prolonged hospitalisation, increased medical costs, poor prognosis, and even death. The objectives of this study were to compare the inciden...

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Autores principales: Liu, Hang, Zhang, Wei, Hu, Qiang, Liu, Lei, Xie, Zhiyang, Xu, Yuzhu, Jing, Genyang, Wang, Yuntao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031251/
https://www.ncbi.nlm.nih.gov/pubmed/36200336
http://dx.doi.org/10.1111/iwj.13948
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author Liu, Hang
Zhang, Wei
Hu, Qiang
Liu, Lei
Xie, Zhiyang
Xu, Yuzhu
Jing, Genyang
Wang, Yuntao
author_facet Liu, Hang
Zhang, Wei
Hu, Qiang
Liu, Lei
Xie, Zhiyang
Xu, Yuzhu
Jing, Genyang
Wang, Yuntao
author_sort Liu, Hang
collection PubMed
description Surgical site infection (SSI) is a common and serious complication of transforaminal lumbar interbody fusion (TLIF), and the occurrence of SSI usually leads to prolonged hospitalisation, increased medical costs, poor prognosis, and even death. The objectives of this study were to compare the incidence of SSI in patients with type 2 diabetes, investigate the correlation between perioperative glycemic variability and postoperative SSI, and develop a nomogram model to predict the risk of SSI. This study retrospectively analysed 339 patients with type 2 diabetes who underwent TLIF in the spinal surgery department of the Affiliated Zhongda Hospital of Southeast University from January 2018 to September 2021. The medical records of all patients were collected, and postoperative infection cases were determined according to the diagnostic criteria of surgical site infection. The risk factors for postoperative SSI were analysed by univariate and multivariate logistic regression. And Nomogram prediction model was established and validated. The nomogram incorporated seven independent predictors. Preoperative FPG‐CV was the most important independent risk predictor of SSI, followed by preoperative MFBG, duration of drain placement, postoperative FPG‐CV, preoperative blood glucose control scheme, duration of diabetes >5 years, and the number of fused vertebrae ≥2. The nomogram showed good diagnostic accuracy for the SS of both the training cohort and the validation cohort (AUC = 0.915 and AUC = 0.890). The calibration curves for the two cohorts both showed optimal agreement between nomogram prediction and actual observation. In conclusion, preoperative and postoperative glycemic variability is closely related to the occurrence of SSI. We developed and validated a nomogram to accurately predict the risk of SSI after TLIF surgery. It's helpful for spinal surgeons to formulate reasonable treatment plans and prevention strategies for type 2 diabetes patients.
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spelling pubmed-100312512023-03-23 A nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability Liu, Hang Zhang, Wei Hu, Qiang Liu, Lei Xie, Zhiyang Xu, Yuzhu Jing, Genyang Wang, Yuntao Int Wound J Original Articles Surgical site infection (SSI) is a common and serious complication of transforaminal lumbar interbody fusion (TLIF), and the occurrence of SSI usually leads to prolonged hospitalisation, increased medical costs, poor prognosis, and even death. The objectives of this study were to compare the incidence of SSI in patients with type 2 diabetes, investigate the correlation between perioperative glycemic variability and postoperative SSI, and develop a nomogram model to predict the risk of SSI. This study retrospectively analysed 339 patients with type 2 diabetes who underwent TLIF in the spinal surgery department of the Affiliated Zhongda Hospital of Southeast University from January 2018 to September 2021. The medical records of all patients were collected, and postoperative infection cases were determined according to the diagnostic criteria of surgical site infection. The risk factors for postoperative SSI were analysed by univariate and multivariate logistic regression. And Nomogram prediction model was established and validated. The nomogram incorporated seven independent predictors. Preoperative FPG‐CV was the most important independent risk predictor of SSI, followed by preoperative MFBG, duration of drain placement, postoperative FPG‐CV, preoperative blood glucose control scheme, duration of diabetes >5 years, and the number of fused vertebrae ≥2. The nomogram showed good diagnostic accuracy for the SS of both the training cohort and the validation cohort (AUC = 0.915 and AUC = 0.890). The calibration curves for the two cohorts both showed optimal agreement between nomogram prediction and actual observation. In conclusion, preoperative and postoperative glycemic variability is closely related to the occurrence of SSI. We developed and validated a nomogram to accurately predict the risk of SSI after TLIF surgery. It's helpful for spinal surgeons to formulate reasonable treatment plans and prevention strategies for type 2 diabetes patients. Blackwell Publishing Ltd 2022-10-06 /pmc/articles/PMC10031251/ /pubmed/36200336 http://dx.doi.org/10.1111/iwj.13948 Text en © 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Liu, Hang
Zhang, Wei
Hu, Qiang
Liu, Lei
Xie, Zhiyang
Xu, Yuzhu
Jing, Genyang
Wang, Yuntao
A nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability
title A nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability
title_full A nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability
title_fullStr A nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability
title_full_unstemmed A nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability
title_short A nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability
title_sort nomogram for accurately predicting the surgical site infection following transforaminal lumbar interbody fusion in type 2 diabetes patients, based on glycemic variability
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10031251/
https://www.ncbi.nlm.nih.gov/pubmed/36200336
http://dx.doi.org/10.1111/iwj.13948
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