Analysis of Factors Influencing Prognosis of Emergency Orthopedic Trauma Patients and Construction and Validation of a Nomogram Model
Objective To analyze the factors affecting the prognosis of emergency patients with orthopedic trauma,and to construct and validate a nomogram model for predicting the risk of prognosis.Methods A total of 312 emergency orthopedic trauma patients admitted to Tangshan Second Hospital from January 2020 to March 2022 were selected.According to whether the pa-tients were alive 28 days after admission,they were divided into survival group(n=260)and death group(n=52).Univariate analysis was conducted to compare the general data,injury severi-ty score(ISS),and serum levels of fibrinogen(FIB),D-dimer(D-D),angiopoietin 2(Ang2)and sol-uble CD14(sCD14)between the two groups.Logistic multivariable regression analysis was used to screen the independent risk factors for the prognosis of emergency orthopedic trauma patients.Based on the obtained independent risk factors,a risk nomogram model was constructed and the predictive performance of the model was validated.Results There were significant differences in the degree of trauma,number of trauma sites,hemorrhagic shock,on-site first aid,ISS,and levels of FIB,D-D,Ang2 and sCD14 between the two groups(P＜0.05).The number of trauma sites≥2(OR=5.802),hemorrhagic shock(OR=16.355),ISS≥18.42(OR=13.782),Ang2≥2 911.15 pg·mL-1(OR=6.821),and sCD14≥4.77 pg·mL-1(OR=9.347)were independent risk factors for the prognosis of emergency patients with orthopedic trauma(P＜0.05).The sensitivity and speci-ficity of the nomogram model constructed from these five factors for predicting prognosis were 90.38%and 79.15%,respectively,with a C-index of 0.978.Conclusion The number of trauma sites,hemorrhagic shock,ISS,Ang2 and sCD14 are factors affecting the prognosis of emergency patients with orthopedic trauma,and the nomogram constructed according to these factors can be used to better predict the prognosis.
万方数据
维普
