Construction of a Column Chart Prediction Model for the Recovery Effect of Finger Replantation Function
Objective To explore the risk factors for poor functional recovery of replanted fingers,and establish a predictive model for poor functional recovery of severed fingers.Methods A retrospective analysis was performed on the data of 309 patients(376 severed fingers)who underwent finger replantation surgery at Tangshan People's Hospital between May 2017 and May 2022.Among them,231 males accounted for 274 severed fingers,while 78 females accounted for 102 severed fingers,with ages ranging from 19 to 67 years,and an average age of(41.57±8.59)years.One year post-surgery,the recovery of severed finger function was assessed,and patients were categorized into a poor recovery group and a control group.Univariate screening was conducted to collect data on patients'general demographic characteristics,disease information,surgical details,and preoperative blood routine indicators.Multivariate analysis was then utilized to identify risk factors for poor finger function recovery,and the effect size of each indicator was visualized in a forest plot.Subsequently,a predictive model using column charts was constructed,and its efficacy was evaluated through the receiver operating characteristic(ROC)curve area under the curve(AUC),calibration curve,and decision curve analysis(DC A).Results Among the 309 patients(376 severed fingers),68 patients(81 severed fingers)exhibited poor postoperative functional recovery,representing 21.54％of the total.Statistically significant differences were observed between the two groups in smoking history,nature of injury,degree of amputation,amputation plane,exposure time of severed fingers,preservation method of severed fingers,and compliance with medical advice on rehabilitation exercise(P＜0.05).Logistic regression analysis revealed that the primary risk factors for poor functional recovery of severed fingers after surgery were smoking history,avulsion injury,amputation plane non-distal to the phalanx,exposure time of severed fingers ≥8 hours,and failure to adhere to medical advice on rehabilitation exercise.Internal validation indicated an AUC of 0.819(95％CI:0.762～0.875),suggesting a high consistency between the model's predicted probability of poor functional recovery and the actual probability.The goodness-of-fit HL test yielded x2=7.389 and P=0.286,further supporting the model's fit.DCA analysis demonstrated that the model exhibited good practicality within a risk threshold ranging from 12％to 75％.Conclusion The column chart model,constructed using variables such as smoking history,nature of injury,level of amputation,exposure time of severed finger,and compliance with medical advice on rehabilitation exercise,demonstrates a robust predictive effect for identifying poor functional recovery of severed fingers following replantation surgery.
severed finger replantationreplanted fingers functionrisk factorsnomogram model
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NSTL
万方数据
