Analysis of influencing factors of postoperative refracture in patients with osteoporotic vertebral compression fractures based on logistic regression and decision tree
Objective To explore the influencing factors of postoperative refracture in patients with osteoporotic vertebral compression fracture (OVCF).Methods A total of 114 patients with OVCF in Hubei Provincial Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Chinese Medicine from January 2019 to January 2022 were selected,and were divided into refracture groups (28 cases) and non-refracture group (86 cases) according to whether or not they had recurrent fractures after surgery.The influencing factors of postoperative refracture in patients with OVCF were analyzed by logistic regression and decision tree.Results Among the 114 OVCF patients,there were 31 males and 83 females,aged from 41 to 89 years,with an average of (74.5±8.9) years.A total of 28 patients with OVCF suffered from postoperative refracture,with an incidence rate of 24.6%.Multifactorial logistic regression analysis showed that OVCF patients with higher BMI (OR=1.437,95%CI:1.123-1.839,P=0.004),previous fracture history (OR=4.572,95%CI:1.115-18.741,P=0.035),bone cement leakage (OR=4.962,95%CI:1.074-22.927,P=0.040),no anti-osteoporosis treatment (OR=0.101,95%CI:0.022-0.467,P=0.003),and lower alkaline phosphatase (OR=0.929,95%CI:0.888-0.972,P=0.001) had higher risk of postoperative refracture.The results of decision tree model show that alkaline phosphatase was the main influencing factor of postoperative refracture in OVCF patients,followed by previous fracture history and anti-osteoporosis treatment.ROC analysis showed that the decision tree AUC was 0.846 (95% CI:0.750-0.943,P<0.001),and the logistic regression AUC was 0.919 (95% CI:0.862-0.975,P<0.001),and there was no statistical difference between the two models (Z=1.720,P=0.085).Conclusions Postoperative refracture in OVCF patients is mainly affected by BMI,previous fracture history,bone cement leakage,anti-osteoporosis treatment,ALP.Postoperative attention should be paid to patients with previous fracture history,low ALP level,and bone cement leakage.Postoperative BMI should be maintained in an appropriate range,and continuous anti-osteoporosis treatment should be actively carried out to reduce the risk of refracture.
万方数据
维普
