关键词: 断指再植； 血管危象； 高危因素； 风险预测； 模型构建； 影响因素

Abstract: Objective To investigate the high risk factors of vascular crisis(VC) after replantation of severed finger,and to construct the corresponding risk prediction model.Methods Data of the cases performed in two hospitals between January 2022 and February 2023 were collected,totaling 183 cases.The patients were divided into VC group (22 cases) and non-VC group (161 cases) according to the occurrence of VC.The risk factors were screened by univariate analysis and multivariate logistic regression analysis,and the corresponding risk prediction model was constructed.Results Univariate analysis showed that smoking history,degree of dissection,ischemic time,cause of injury,arterial repair and venous repair were related to the occurrence of vascular crisis(P＜0.05).Multivariate logistic regression analysis showed that smoking history,degree of detachment and ischemic time are the risk factors for vascular crisis(P＜0.05).Based on the risk factors of vascular crisis,a line graph model was established for the occurrence of vascular crisis after replantation of severed finger.The area under ROC curve was 0.963,the sensitivity was 91.7%,and the specificity was 96.0%,indicating that this model has a good risk prediction ability.Conclusion Smoking history,degree of amputation and ischemic time were independent risk factors for vascular crisis after finger replantation.The constructed risk prediction model can provide clinicians with postoperative risk assessment and prediction,which is helpful to formulate targeted treatment plans and reduce the incidence of postoperative complications.

Key words: finger replantation; vascular crisis; high risk factors; risk prediction; model construction; influencing factors