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Updated: Jul 25, 2026

Automated Midline Shift and Intracranial Pressure Estimation based on Brain CT Images
Published on: April 13, 2013
Risk factors and the nomogram model for intraoperatively acquired pressure injuries in children with brain tumours: A
Hong Qu1, Xurong Tang1, Wei Zeng1
1Department of Operation Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Insights
This study identified key risk factors for Intraoperatively Acquired Pressure Injuries (IAPIs) in pediatric brain tumor patients. A predictive nomogram model was developed to guide prevention strategies, improving patient care.
Area of Science:
- Pediatric Neurosurgery
- Surgical Patient Safety
- Medical Informatics
Background:
- Intraoperatively Acquired Pressure Injuries (IAPIs) are a concern in pediatric neurosurgery.
- Understanding risk factors and developing predictive tools for IAPIs is crucial for prevention.
Purpose of the Study:
- To investigate clinical features and incidence of IAPIs in children undergoing brain tumor surgery.
- To identify risk factors associated with IAPIs.
- To develop and validate a nomogram model for predicting IAPIs.
Main Methods:
- Retrospective analysis of 628 pediatric patients undergoing brain tumor surgery.
- Univariate and multivariate analyses to identify risk factors.
- Development and validation of a nomogram using R software, AUC, calibration plots, and DCA.
Main Results:
- Age, hemorrhage, vasopressor use, temperature, operation time, and position were significant risk factors.
- The nomogram demonstrated satisfactory predictive discrimination and calibration in both training and validation cohorts.
- Decision curve analysis confirmed the clinical utility and net benefit of the nomogram model.
Conclusions:
- A validated nomogram model effectively predicts the risk of IAPIs in pediatric brain tumor patients.
- The model provides scientific and individualized guidance for developing targeted prevention strategies.
- This tool can enhance patient safety and reduce the incidence of IAPIs during surgery.
Abstract:
This study aimed to investigate the clinical features and incidence of Intraoperatively Acquired Pressure Injuries (IAPIs) of brain tumours in children, to screen the risk factors and to establish a nomogram model for making prevention strategies against the development of IAPIs. Clinical data of 628 children undergoing brain tumour surgery from August 2019 to August 2021 were extracted from the adverse events and the electronic medical systems. They were randomly divided into a training cohort(n = 471) and a validation cohort(n = 157). The univariate and multivariate analysis was performed to identify the risk factors in training cohort; R software was used to construct a nomogram model; the area under the receiver operator characteristic curve (AUC) and calibration plots were used to judge the predictive performance of the nomogram model; decision curve analysis (DCA) was used to assess the clinical usefulness of the nomogram model. Age, haemorrhage, use of vasopressor, temperature, operation time and operation position were considered as significant risk factors, and enrolled to construct a nomogram model. The results of AUC showed satisfactory discrimination of the nomogram; the calibration plots indicated favourable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts; DCA showed better net benefit and threshold probability of the nomogram model. The nomogram model illustrates significant predictive ability, which can provide scientific and individual guidance for preventing development of IAPIs.
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Increased Intracranial Pressure l: Introduction
Increased Intracranial Pressure ll: Pathophysiology

