Validity and Utility of a Risk Prediction Model for Wound Infection After Lower Third Molar Surgery.

IF 2.9 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral diseases Pub Date : 2025-01-10 DOI:10.1111/odi.15243

Akira Yamagami, Katsuya Narumi, Yoshitaka Saito, Ayako Furugen, Shungo Imai, Keisuke Okamoto, Yoshimasa Kitagawa, Yoichi Ohiro, Ryo Takagi, Yoh Takekuma, Mitsuru Sugawara, Masaki Kobayashi

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引用次数: 0

Abstract

Objectives: To externally validate a clinical prediction model for surgical site infection (SSI) after lower third molar (L3M) surgery and evaluate its clinical usefulness.

Methods: We conducted a retrospective cohort study of patients who underwent L3M surgery at Hokkaido University Hospital. The study was designed to evaluate the historical and methodological transportability. Clinical usefulness was evaluated using decision curve analysis on the data of the non-antibiotic-treated patients.

Results: We obtained 2543 validation cohorts from April 2020 to March 2023, and 640 non-antibiotic cohorts from July 2010 to September 2023. The incidences of SSI after L3M surgery were 5.3% (135/2543) and 7.7% (49/640) in the validation and non-antibiotic cohorts, respectively. The discrimination ability of the prediction model was acceptable for the external validation cohort (c-statistic: 0.67; 95% CI: 0.62-0.71) and adequate for the non-antibiotic cohort (c-statistic: 0.72; 95% CI: 0.63-0.79). In both cohorts, the model showed excellent calibration between the observed and predicted probabilities. Decision curve analysis showed increased net benefit across a range of meaningful risk thresholds.

Conclusion: A simple risk prediction model for SSI after L3M surgery demonstrated clinical transportability and usefulness. This model may help surgeons/clinicians determine the appropriateness of prophylactic antibiotics administration for patients in L3M surgery.

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下第三磨牙手术后伤口感染风险预测模型的有效性和实用性。

目的：外部验证下第三磨牙（L3M）术后手术部位感染（SSI）的临床预测模型，并评价其临床应用价值。方法：我们对在北海道大学医院行L3M手术的患者进行回顾性队列研究。该研究旨在评估历史和方法上的可移植性。对未使用抗生素治疗的患者的数据进行决策曲线分析，评价临床有用性。结果：我们从2020年4月至2023年3月获得了2543个验证队列，从2010年7月至2023年9月获得了640个非抗生素队列。在验证组和非抗生素组中，L3M术后SSI的发生率分别为5.3%（135/2543）和7.7%（49/640）。预测模型的鉴别能力在外部验证队列中是可接受的(c-statistic: 0.67；95% CI: 0.62-0.71)，对于非抗生素队列是足够的(c-统计量：0.72；95% ci: 0.63-0.79)。在两个队列中，该模型在观察到的概率和预测的概率之间显示出良好的校准。决策曲线分析显示，在一系列有意义的风险阈值范围内，净收益增加。结论：一个简单的L3M术后SSI风险预测模型具有临床可移植性和实用性。该模型可以帮助外科医生/临床医生确定L3M手术患者预防性抗生素给药的适当性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral diseases 医学-牙科与口腔外科

CiteScore

7.60

自引率

5.30%

发文量

325

审稿时长

4-8 weeks

期刊介绍： Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.