关键词: 后路矫形术, 脊柱侧弯, 压力性损伤, 预测模型

Abstract: Objective  The aim of this study was to investigate the high risk factors of intraoperative stress injury in children with posterior spinal scoliosis and to construct a corresponding risk prediction model.Methods  A total of 237 cases of orthopaedic surgery for posterior scoliosis performed in three first-class hospitals in Changsha City from October 2021 to February 2023.The patients were divided into injury group (31 cases) and uninjured group (206 cases) according to whether stress injury occurred.The risk factors were screened by single factor analysis and multiple Logistic-regression analysis,and the corresponding risk prediction model was constructed.Results  The results of single factor analysis showed that constitutional index,preoperative skin condition,preoperative hypoproteinemia,preoperative anemia,operative time,intraoperative body temperature and intraoperative bleeding were related to the occurrence of vascular crisis.BMI,preoperative skin condition,preoperative hypoproteinemia,operative time and intraoperative bleeding are high risk factors for the occurrence of intraoperative stress injury in children with posterior scoliosis.The area under ROC curve is 0.612,the sensitivity is 89.7%,and the specificity is 91.0%,indicating that this model has good risk prediction ability.Conclusion  BMI,preoperative skin condition,preoperative hypoproteinemia,operative time and intraoperative bleeding are high risk factors for the occurrence of intraoperative stress injury in children with posterior scoliosis.

Key words: Posterior orthosis, Scoliosis, Stress injury, Prediction model