Construction and evaluation of prognosis prediction model for amputation patients with diabetes foot ulcer Sun
Jia* ，Gao Qian，Zhou Yan，Chen Li． * Wound Center of Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong
University，Shanghai 200092，China
Corresponding author: Zhou Yan，E-mail: 13391086040@ 163． com
Funding program: Scientific Ｒesearch Program of Shanghai Municipal Commission of Science and Technology( 20401903107)
【Abstract】 Objective To establish and evaluate the nomogram prediction model of the factors influencing the poor
prognosis of amputation patients with diabetes foot ulcer． Methods From August 2018 to June 2021，122 amputees with dia-
betes foot ulcer were selected from the Wound Center and Endocrine Department of Xinhua Hospital Affiliated to Shanghai
Jiaotong University School of Medicine． They were followed up for one year after surgery． According to whether there were ad-
verse events during the follow-up period，they were divided into a good prognosis group of 76 cases and a bad prognosis group
of 46 cases． Collect general data of patients and preoperative laboratory indicators; Single factor analysis and multivariate Cox
risk regression analysis were used to screen the influencing factors of poor prognosis of diabetes foot ulcer patients after amputa-
tion，Ｒ software was included in the influencing factors to establish a nomogram prediction model，and the ability of the nomo-
gram to predict the poor prognosis of diabetes foot ulcer patients after amputation was evaluated through the subject＇s work char-
acteristic curve ( ＲOC) and calibration curve． Ｒesults The proportion of family history of diabetes，neutrophil / lymphocyte
ratio ( NLＲ) ，C-reactive protein ( CＲP) ，D-dimer ( D-D) levels in poor prognosis group were higher than those in good prog-
nosis group ［χ2 ( t) / P = 5． 025 /0． 025，6． 803 / ＜ 0． 001，3． 229 /0． 002，6． 752 / ＜ 0． 001］，the level of albumin ( Alb) was
lower than that of the group with good prognosis ( t / P = 2． 564 /0． 012) ． Multivariate Cox risk regression analysis showed that
high NLＲ，CＲP and D-D were risk factors for poor prognosis of amputees with diabetes foot ulcer ［HＲ ( 95% CI) = 1． 520
( 1． 193 － 1． 935) ，1． 041 ( 1． 018 － 1． 066) ，3． 771 ( 2． 059 － 6． 908) ］，and high Alb was a protective factor ［HＲ ( 95%
CI) = 0． 934 ( 0． 888 － 0． 982) ］． The validation results of the nomograph prediction model based on the influence factors show
·482· 疑难病杂志 2023 年 3 月第 22 卷第 3 期 Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3

that the area under the ＲOC curve is 0． 861 ( 95% CI 0． 786 － 0． 936) ，and the calibration curve is a straight line with a slope
of approximately 1． Conclusion The nomogram prediction model based on the influencing factors of poor prognosis of ampu-
tation patients with diabetes foot ulcer has good discrimination and consistency，and has certain guiding value for the formula-
tion of countermeasures for amputation patients with diabetes foot ulcer．
【Key words】 Diabetic foot ulcer; Amputation; Poor prognosis; Influence factor; Nomogram