目的:本研究评估CT表现的预后价值,包括体积测量,在预测Fournier坏疽(FG)患者的预后时,关注死亡率,入住ICU,住院时间,和医疗费用。
方法:对38例FG患者进行了回顾性研究,这些患者在手术清创前接受了CT扫描。我们分析了人口统计数据,CT容积测量,和临床结果使用logistic和线性回归模型。
结果:没有一项CT测量能显著预测死亡率或ICU入住。死亡率预测的最佳模型包括年龄,风量,NSTI得分,和男性,AUC为0.911。插管可能性建模AUC为0.913,使用年龄,NSTI得分,内脏与皮下脂肪的比例。ICU入院模型的AUC为0.677。住院时间由空气量预测(β=0.0002656,p=0.0505),调整后的R平方为0.1287。风量显著预测医院成本(β=2.859,p=0.00558),导致调整后的R平方为0.2165。
结论:体积CT检查结果为FG患者提供了有价值的预后见解,为明智的临床决策和资源分配提供依据。在更大的进一步验证,建议多中心研究为FG结果开发稳健的预测模型。
OBJECTIVE: This study evaluates the prognostic value of CT findings, including volumetric measurements, in predicting outcomes for patients with Fournier gangrene (FG), focusing on mortality, ICU admission, hospital stay length, and healthcare costs.
METHODS: A retrospective study was conducted on 38 FG patients who underwent CT scans before surgical debridement. We analyzed demographic data, CT volumetric measurements, and clinical outcomes using logistic and linear regression models.
RESULTS: No single CT measurement significantly predicted mortality or ICU admission. The best model for mortality prediction included age, air volume, NSTI score, and male sex, with an AUC of 0.911. Intubation likelihood was modeled with an AUC of 0.913 using age, NSTI score, and visceral to subcutaneous fat ratio. The ICU admission model achieved an AUC of 0.677. Hospital stay was predicted by air volume (β = 0.0002656, p = 0.0505) with an adjusted R-squared of 0.1287. Air volume significantly predicted hospital costs (β = 2.859, p = 0.00558), resulting in an adjusted R-squared of 0.2165.
CONCLUSIONS: Volumetric CT findings provide valuable prognostic insights for FG patients, suggesting a basis for informed clinical decisions and resource allocation. Further validation in larger, multi-center studies is recommended to develop robust predictive models for FG outcomes.