美国 Susan Horn 博士的研究慢性伤口患者伤口愈合指数的发展(Development of a wound healing index for patients with chronic wounds) ，确定患者的初始状况，将影响伤口愈合，而无论治疗对病人的影响和伤口的特点。这项研究是第一个确定了难愈性伤口患者，需要更积极的护理以及一个有效的治疗指导。
Randomized controlled trials in wound care generalize poorly because they exclude patients with significant comorbid conditions. Research using real-world wound care patients is hindered by lack of validated methods to stratify patients according to severity of underlying illnesses. We developed a comprehensive stratification system for patients with wounds that predicts healing likelihood. Complete medical record data on 50,967 wounds from the United States Wound Registry were assigned a clear outcome (healed, amputated, etc.). Factors known to be associated with healing were evaluated using logistic regression models. Significant variables (p 0.05) were determined and subsequently tested on a holdout sample of data. A different model predicted healing for each wound type. Some variables predicted significantly in nearly all models: wound size, wound age, number of wounds, evidence of bioburden, tissue type exposed (Wagner grade or stage), being nonambulatory, and requiring hospitalization during the course of care. Variables significant in some models included renal failure, renal transplant, malnutrition, autoimmune disease, and cardiovascular disease. All models validated well when applied to the holdout sample. The “Wound Healing Index” can validly predict likelihood of wound healing among real-world patients and can facilitate comparative effectiveness research to identify patients needing advanced therapeutics.
Development of a wound healing index for patients with chronic wounds – Susan Horn – Salt Lake City – USA