DEVELOPING A NOMOGRAM FOR PREDICTING VENTILATION PRESSURE INJURY IN ATHLETES IN THE PRONE POSITION FOLLOWING CARDIAC SURGERY

Abstract

Objective: This study aims to assess the risk factors for pressure injuries in athletes undergoing cardiac surgery with prone position ventilation, develop a risk prediction model, and validate it internally to enhance preventive strategies. Methods: We retrospectively analyzed 164 athletes who required prone position ventilation post-cardiac surgery at a 3A hospital in Chongqing City from January 2021 to December 2022. Patients were categorized into two groups based on the occurrence of pressure injuries: the occurrence group (n=70) and the non-occurrence group (n=94). Risk factors were identified, and a predictive model was constructed using logistic regression, followed by internal validation. Results: Among the patients, 42.68% (70/164) suffered pressure injuries, predominantly at stage I, with cheeks being the most common sites. Multivariate analysis identified age, sex, abnormal cardiac function, prone position ventilation time exceeding 15 hours, and the use of multiple vasopressors as independent risk factors. A predictive model was created based on these factors, demonstrating an area under the ROC curve of 0.967 (95% CI: 0.945 - 0.990). The model showed high sensitivity (91.49%) and specificity (82.86%), with excellent fit (Hosmer-Lemeshow test χ2=2.562, P=0.959) and good calibration upon bootstrap validation. Decision Curve Analysis (DCA) indicated clinical utility. Conclusion: The developed nomogram for predicting pressure injury risk in athletes requiring prone ventilation post-cardiac surgery exhibits robust predictive accuracy. This tool can effectively identify high-risk athletes, enabling early intervention and tailored care strategies to mitigate pressure injuries. Such predictive models are essential in sports medicine to ensure rapid recovery and minimize complications for athletes returning to training and competition.