Current Situation And Related Factors Of Intra-operative Pressure Ulcer In Adult Cardiovascular Surgery

Objective: To investigate the current situation of intra-operative pressure ulcer in adult patients with cardiovascular surgery and to explore the related factors;To establish a predictive model for high risk patients with intra-operative pressure ulcer in cardiovascular surgery and to verify the application effect of the model and to lay the foundation for the implementation of targeted nursing intervention.Methods: Through a cross-sectional survey of 1163 patients undergoing cardiovascular surgery,the incidence,location and prognosis of intra-operative pressure ulcer were described.To explore the risk factors influencing the occurrence of intra-operative pressure ulcer;Through logistic regression analysis,a model was constructed to predict the high-risk population of intra-operative pressure ulcer in adult cardiovascular surgery patients.The diagnostic results of International Pressure Ulcer Classification Standard were taken as the approximate gold standard,and the best critical value was determined by ROC curve drawing.The predictive model was validated in 443 patients undergoing cardiovascular surgery.Results : The occurrence rate of intra-operative pressure ulcer in adult cardiovascular surgery was 19.86%.The results of Logistic regression analysis: the probability of occurrence of intraoperative pressure ulcer(Logit P)=-11.745+0.024* preoperative hemoglobin value + 0.118 *preoperative blood sodium levels-0.014*prealbumin levels-0.213* average temperature during surgery-0.058* the lowest mean arterial pressure during surgery+ 0.646* preoperative serum potassium values + 0.264* smoking history+0.760* history of hypertension +0.536*aged 70 years and above.After drawing the ROC curve,the critical value of LogitP is-1.25912(under the curve area AUC=0.751).This model is proved empirically,suggesting that it has a good prediction effect,that is,sensitivity =65.67%,specificity =79.26%,misdiagnosis rate(false positive rate)=20.74%,omission rate(false negative rate)=34.33%.Conclusions: The incidence of intraoperative pressure ulcer was high in adult patients undergoing cardiovascular surgery.The prediction model of high-risk population constructed in this study has good prediction effect and can be applied in clinic.