针脚部位的炎症能否通过热成像检测出来?美国和丹麦对使用外固定器治疗的患者进行的横断面研究。

IF 2.5 2区 医学 Q1 ORTHOPEDICS Acta Orthopaedica Pub Date : 2024-09-23 DOI:10.2340/17453674.2024.41901
Marie Fridberg, Ole Rahbek, Hans-Christen Husum, Bafor Anirejuoritse, Kirsten Duch, Christopher Iobst, Søren Kold
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引用次数: 0

摘要

背景和目的:使用外固定器的患者存在针脚部位感染的风险。我们需要一种工具来客观监测针脚部位是否出现感染迹象。我们的目的是使用热成像技术研究清洁和明显发炎的针脚部位之间的温度(MaxTp)差异,并使用热成像技术确定 MaxTp 的最佳临界值,作为炎症检测的筛查工具: 这是一项在美国和丹麦进行的横断面研究,研究对象是使用圆形外固定器的患者。由外科医生或护士目测针脚部位是否清洁或有发炎迹象。通过使用红外热像仪(FLIR T540)进行热成像,获得插针部位的 MaxTp: 结果:我们纳入了 83 名患者的 1,970 个针刺部位。清洁针刺部位(n = 1 739)的平均 MaxTp 为 33.1°C(95% 置信区间 [CI] 为 32.8-33.4),肉眼可见发炎针刺部位(n = 231)的平均 MaxTp 为 34.0°C(CI 为 33.6-34.3)。在对患者和针刺部位的重复观察进行调整后,平均差异为 0.9°C (CI 0.7-1.1),具有显著的统计学意义(P < 0.001)。MaxTp 作为检测炎症视觉征兆的筛查工具的接收者工作特征曲线下面积为 0.71 (CI 0.65-0.76)。经验上的最佳临界值为 34.1°C,灵敏度为 65%,特异性为 72%,阳性预测值为 23%,阴性预测值为 94%: 我们发现,在有和没有肉眼可见炎症迹象的针刺部位,平均温度的差异具有统计学意义。热成像技术有望成为未来监测针刺部位周围炎症的护理点技术工具。
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Can pin-site inflammation be detected with thermographic imaging? A cross-sectional study from the USA and Denmark of patients treated with external fixators.

Background and purpose:  Patients with external fixators are at risk of pin-site infection. A tool for objective monitoring of pin sites for evolving signs of infection is warranted. We aimed to investigate the temperature (MaxTp) difference between clean and visually inflamed pin sites using thermography and to establish the optimal cut-off value of MaxTp using thermography as a screening tool for inflammation detection.

Methods:  This was a cross-sectional study performed in the USA and Denmark of patients with circular external fixators. Pin sites were visually judged by a surgeon or a nurse as clean or as showing signs of inflammation. The MaxTp was obtained at the pin site by thermographic imaging using an infrared camera (FLIR T540).

Results:  We included 1,970 pin sites from 83 patients. The mean MaxTp for clean pin sites (n = 1,739) was 33.1°C (95% confidence interval [CI] 32.8-33.4) and the mean MaxTp for visual inflamed pin sites (n = 231) was 34.0°C (CI 33.6-34.3). The mean difference, when adjusted for repeated observations of patients and pin sites, was statistically significant with a difference of 0.9°C (CI 0.7-1.1) (P < 0.001). The area under the receiver operating characteristic curve for MaxTp as a screening tool to detect visual signs of inflammation was 0.71 (CI 0.65-0.76). The empirically optimal cut-off value was 34.1°C with a sensitivity of 65%, a specificity of 72%, a positive predictive value of 23%, and a negative predictive value of 94%.

Conclusion:  We found a statistically significant difference in mean temperature between pin sites with and without visual signs of inflammation. Thermography could be a promising tool for future point of care technology for monitoring inflammation around pin sites.

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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
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