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Nomogram model to predict postoperative infection after mandibular osteoradionecrosis surgery
Zhonglong Liu1, Tianguo Dai1,2, Zhonghe Wang3
1Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Scientific Reports
|June 16, 2017
Summary
This study identifies key risk factors for postoperative infection in osteoradionecrosis of the mandible (ORNM) patients. Developed risk-stratification scores and a nomogram model can effectively predict infection risk, aiding in prophylaxis and intervention.
Area of Science:
- Oral and Maxillofacial Surgery
- Oncology
- Radiotherapy
Background:
- Osteoradionecrosis of the mandible (ORNM) is a severe complication following radiotherapy.
- Impaired soft tissue healing post-radiation increases surgical failure risk.
- Identifying prognostic factors for postoperative infection (PPI) is crucial for ORNM management.
Purpose of the Study:
- To identify prognostic factors for postoperative infection (PPI) in patients with osteoradionecrosis of the mandible (ORNM).
- To develop risk-stratification scores and a nomogram model for predicting PPI.
- To propose corresponding prophylaxis and intervention protocols based on identified risk factors.
Main Methods:
- A retrospective study analyzed 257 ORNM patients treated between 2000 and 2015.
- Multiple logistic regression was used to identify significant prognostic factors for PPI.
- A risk-stratification score and a nomogram model were developed and validated using ROC curve analysis (AUC=0.708).
Main Results:
- The overall incidence of PPI was 23.3%.
- Significant PPI predictors included radiation dose ≥80 Gy, bilateral ORNM, skin fistula, and implant utilization.
- The risk-stratification score demonstrated a clear gradient of PPI susceptibility across different score ranges.
Conclusions:
- Established risk-stratification scores and nomogram models effectively predict PPI risk in ORNM patients.
- These predictive tools can guide targeted prophylaxis and intervention strategies.
- Further research may refine these models for improved clinical application in ORNM care.
