湖北省潜江市某三甲医院蝮蛇咬伤继发组织坏死的影响因素及预测模型构建OA

Objective To explore the influencing factors and prediction model construction of tissue necrosis secondary to viper bite.Methods The clinical data of 81 patients with viper bites admitted to the emergency department of Qianjiang Central Hospital from February 1,2021 to July 31,2024 were retrospectively analyzed.All patients completed blood routine,biochemical and other laboratory indexes after admission.According to whether tissue necrosis occurred,they were divided into tissue necrosis group and non-necrotic group.The general baseline data of the patients were analyzed.LASSO regression was used to screen the independent variables,and multivariate Logistic regression was used to obtain the risk factors.The nomogram was constructed based on R language,and the ROC curve,calibration curve and clinical decision curve were drawn.Results The incidence of tissue necrosis was 45.68%(37/81)in patients bitten by viper.There were significant differences in age,heart rate,season,white blood cells,neutrophils,lymphocytes,ALT,AST,hospitalization time and SSS between the two groups(P<0.05).The independent variables screened by LASSO regression were neutrophils,heart rate,SSS and hospitalization time.Further Logistic regression analysis was used to determine that neutrophils,heart rate and SSS were independent risk factors for patients with viper bite.The AUC of neutrophil,heart rate,SSS and the combined ROC curve for predicting tissue necrosis were 0.894,0.666,0.943 and 0.991,respectively.Conclusion Neutrophils,heart rate,and SSS are independent risk factors for viper bites.This modeling has a high degree of fitting and clinical adaptability.The combined detection of the three has a good predictive value for tissue necrosis in patients with viper bites.