Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score

ZHU Xin-yue; XU Tian-ning; SI Lin-jie; XU Wen-ting; GENG Dan-dan

doi:10.11659/jjssx.08E025110

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Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score

Cardiovascular Surgery Column | 更新时间：2026-03-09

- Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 2, Pages: 93-97(2026)
- 作者机构：
  
  南京医科大学第一附属医院心脏大血管外科监护，江苏南京 210029
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E025110
  CLC： R473.6
- Received：28 August 2025，
  
  Published：25 February 2026
- 稿件说明：
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朱鑫玥,徐天宁,司林杰等.基于DynNom动态评分构建心脏搭桥术后压力性损伤的风险预测模型[J].局解手术学杂志,2026,35(02):93-97.

ZHU Xin-yue,XU Tian-ning,SI Lin-jie,et al.Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):93-97.
朱鑫玥,徐天宁,司林杰等.基于DynNom动态评分构建心脏搭桥术后压力性损伤的风险预测模型[J].局解手术学杂志,2026,35(02):93-97. DOI： 10.11659/jjssx.08E025110.

ZHU Xin-yue,XU Tian-ning,SI Lin-jie,et al.Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):93-97. DOI： 10.11659/jjssx.08E025110.

摘要

目的

分析心脏搭桥术后压力性损伤的危险因素，建立心脏搭桥术后压力性损伤的列线图模型。

方法

选取2021年2月至2024年12月我院收治的262例心脏搭桥术患者作为研究对象，根据心脏搭桥术后压力性损伤发生情况将其分为压力性损伤组和无压力性损伤组。比较2组患者的临床资料。采用

LASSO

分析筛选心脏搭桥术后压力性损伤的预测因素，采用

Logistic

回归模型筛选心脏搭桥术后压力性损伤的危险因素，采用R4.2.3软件建立心脏搭桥术后压力性损伤的列线图模型，并对心脏搭桥术后压力性损伤的列线图模型进行验证。

结果

262例心脏搭桥术患者中，有73例（27.86%）发生压力性损伤。2组患者的体外循环、使用血管活性药物、手术时间、肾功能不全、糖尿病、肥胖等资料比较，差异均有统计学意义（

0.05）。

Logistic

回归分析结果显示，体外循环、使用血管活性药物、手术时间≥4 h、肾功能不全、糖尿病、肥胖均是心脏搭桥术后压力性损伤的危险因素（

0.05）。心脏搭桥术后压力性损伤的列线图模型的受试者工作特征曲线下面积是0.796（95%

：0.738~0.854）；

Hosmer-Lemeshow

检验结果显示

=2.128，

=0.952，校正曲线的预测值和实际值基本拟合；决策曲线分析显示阈值概率是5%~100%时，列线图对心脏搭桥术后压力性损伤的预测具有良好的获益值。

结论

体外循环、使用血管活性药物、手术时间≥4 h、肾功能不全、糖尿病、肥胖均是心脏搭桥术后压力性损伤的危险因素，心脏搭桥术后压力性损伤的列线图模型准确性尚可。

Abstract

Objective

To analyze the risk factors of pressure injuries after coronary artery bypass grafting and establish a nomogram model for pressure injuries after coronary artery bypass grafting.

Methods

A total of 262 patients who underwent co

ronary artery bypass grafting in our hospital from February 2021 to December 2024 were selected as the research subjects and they were divided into the pressure injury group and the non-pressure injury group based on the occurrence of pressure injuries after coronary artery bypass grafting. The clinical data of patients in the two groups were compared.

LASSO

analysis was used to screen the predictive factors of pressure injuries after coronary artery bypass grafting，

Logistic

regression model was used to screen the risk factors of pressure injuries after coronary artery bypass grafting. A nomogram model for pressure injuries after coronary artery bypass grafting was established by R4.2.3 software， and the nomogram model of pressure injuries after coronary artery bypass grafting was verified.

Results

Among 262 patients who underwent coronary artery bypass grafting， 73 cases （27.86%） developed pressure injuries. There were statistically significant differences in terms of cardiopulmonary bypass， use of vasoactive drugs， operation time， renal insufficiency， diabetes and obesity between the two groups （

0.05）.

Logistic

regression analysis showed that cardiopulmonary bypass， use of vasoactive drugs， operation time ≥ 4 hours， renal insufficiency， diabetes and obesity were the risk factors for pressure injuries after coronary artery bypass grafting （

0.05）. The

area under the

receiver operating characteristic curve

of the nomogram model for pressure injuries after coronary artery bypass grafting was 0.796 （95%

： 0.738 to 0.854）；

Hosmer

Lemeshow

test results showed that

=2.128，

=0.952， and the predicted value and actual value of the calibration curve were basically fitted； the

decision curve analysis

showed that when the threshold probability was 5% t

o 100%， the nomogram had good benefit value for predicting pressure injuries after coronary artery bypass grafting.

Conclusion

Cardiopulmonary bypass， use of vasoactive drugs， operation time ≥ 4 hours， renal insufficiency， diabetes， and obesity are the risk factors for pressure injuries after coronary artery bypass grafting， and the nomogram model for pressure injuries after coronary artery bypass grafting has acceptable accuracy.

关键词

Keywords

references

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