Construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone position

Abstract Objective To construct a model for predicting the risk of IAPI (Intraoperative acquired pressure injury) in the facial area of patients undergoing prone position surgery and to validate the predictive effectiveness of this model. Methods We analyzed data from 970 patients who underwent pron...

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Main Authors: Wei Li, Jing Huang, Hua Li, Tingchun Gou, Ling Tang, Xuesu Dong, Chunmei Luo
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-03024-2
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author Wei Li
Jing Huang
Hua Li
Tingchun Gou
Ling Tang
Xuesu Dong
Chunmei Luo
author_facet Wei Li
Jing Huang
Hua Li
Tingchun Gou
Ling Tang
Xuesu Dong
Chunmei Luo
author_sort Wei Li
collection DOAJ
description Abstract Objective To construct a model for predicting the risk of IAPI (Intraoperative acquired pressure injury) in the facial area of patients undergoing prone position surgery and to validate the predictive effectiveness of this model. Methods We analyzed data from 970 patients who underwent prone position surgery at a tertiary general hospital in Chongqing, China, from January 2022 to October 2022. Using univariate analysis and logistic regression analysis, we identified risk factors for IAPI in the maxillofacial region of patients undergoing prone position surgery and constructed a nomogram prediction model using R software. On the basis of the selected predictive factors, a risk prediction model was constructed and evaluated using the concordance index (C-index) and the area under the curve (AUC). External validation was conducted to verify the model’s performance. Results The incidence of IAPI in prone surgery patients was 17.8%. Multivariate logistic regression analysis revealed that BMI, history of diabetes, surgical duration, muscle relaxant dosage, history of allergies, and preoperative Braden score were the most important factors for the occurrence of intraoperative pressure injuries in the facial region of patients who underwent prone position surgery (P < 0.05). The area under the ROC curve of the prediction model is 0.863, the maximum Youden index is 0.681, the optimal cutoff value is 0.214, the sensitivity is 0.815, the specificity is 0.866, and the accuracy in actual application is 91.1%. Conclusions The IAPI risk prediction model for maxillofacial surgery patients in the prone position constructed in this study demonstrated good predictive performance, providing a basis for clinical medical staff to quickly identify high-risk patients and implement precise intervention plans before surgery.
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spelling doaj-art-dca8dd143a7c4f689238912dd2d74ed72025-08-20T03:45:24ZengBMCBMC Surgery1471-24822025-07-0125111010.1186/s12893-025-03024-2Construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone positionWei Li0Jing Huang1Hua Li2Tingchun Gou3Ling Tang4Xuesu Dong5Chunmei Luo6Department of Anesthesiology, Xinqiao Hospital, Army Medical UniversityDepartment of Anesthesiology, Xinqiao Hospital, Army Medical UniversityDepartment of Anesthesiology, Xinqiao Hospital, Army Medical UniversityDepartment of Anesthesiology, Xinqiao Hospital, Army Medical UniversityDepartment of Anesthesiology, Xinqiao Hospital, Army Medical UniversityDepartment of Anesthesiology, Xinqiao Hospital, Army Medical UniversityDepartment of Orthopedics, Xinqiao Hospital, Army Medical UniversityAbstract Objective To construct a model for predicting the risk of IAPI (Intraoperative acquired pressure injury) in the facial area of patients undergoing prone position surgery and to validate the predictive effectiveness of this model. Methods We analyzed data from 970 patients who underwent prone position surgery at a tertiary general hospital in Chongqing, China, from January 2022 to October 2022. Using univariate analysis and logistic regression analysis, we identified risk factors for IAPI in the maxillofacial region of patients undergoing prone position surgery and constructed a nomogram prediction model using R software. On the basis of the selected predictive factors, a risk prediction model was constructed and evaluated using the concordance index (C-index) and the area under the curve (AUC). External validation was conducted to verify the model’s performance. Results The incidence of IAPI in prone surgery patients was 17.8%. Multivariate logistic regression analysis revealed that BMI, history of diabetes, surgical duration, muscle relaxant dosage, history of allergies, and preoperative Braden score were the most important factors for the occurrence of intraoperative pressure injuries in the facial region of patients who underwent prone position surgery (P < 0.05). The area under the ROC curve of the prediction model is 0.863, the maximum Youden index is 0.681, the optimal cutoff value is 0.214, the sensitivity is 0.815, the specificity is 0.866, and the accuracy in actual application is 91.1%. Conclusions The IAPI risk prediction model for maxillofacial surgery patients in the prone position constructed in this study demonstrated good predictive performance, providing a basis for clinical medical staff to quickly identify high-risk patients and implement precise intervention plans before surgery.https://doi.org/10.1186/s12893-025-03024-2Pressure ulcerProne positionMaxillofacialNomogramPrediction model
spellingShingle Wei Li
Jing Huang
Hua Li
Tingchun Gou
Ling Tang
Xuesu Dong
Chunmei Luo
Construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone position
BMC Surgery
Pressure ulcer
Prone position
Maxillofacial
Nomogram
Prediction model
title Construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone position
title_full Construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone position
title_fullStr Construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone position
title_full_unstemmed Construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone position
title_short Construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone position
title_sort construction and validation of a predictive model for the risk of intraoperative acquired pressure injuries in the maxillofacial region in patients undergoing surgery in the prone position
topic Pressure ulcer
Prone position
Maxillofacial
Nomogram
Prediction model
url https://doi.org/10.1186/s12893-025-03024-2
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