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.

objectiveTo 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.

methodsWe 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.

resultsThe 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%.

conclusionsThe 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.