A nomogram model for individualized prediction of deep vein thrombosis in elderly patients with lumbar disc herniation after micro endoscopic discectomy surgery
Objective To establish a nomogram model for predicting the occurrence of deep vein thrombosis(DVT)after micro endoscopic discectomy(MED)in elderly patients(ages 80 and older)with lumbar disc herniation,and to verify the accuracy and clinical applicability of the model.Methods The clinical data of 912 elderly patients with lumbar disc herniation who underwent MED surgery at our hospital between 2013 and 2022 was retrospectively analyzed.These patients were divided into a DVT group and a non-DVT group based on the postoperative occurrence of DVT.Univariate and multivariate logistic regression analysis was conducted to identify independent risk factors for the development of DVT after surgery.A nomogram model was constructed based on these independent risk factors using the R language package.The accuracy and clinical decision-making benefits of the model were validated using the ROC curve,the Bootstrap method,and clinical decision curves.Results In the non-DVT group,there were 834 patients,compared with 78 patients in the DVT group.Multivariate logistic regression analysis identified the following independent risk factors for DVT after MED surgery in elderly patients with lumbar disc herniation:elevated D-dimer levels,history of cerebrovascular disease,diabetes,and history of deep vein thrombosis.The ROC curve validation of the nomogram model showed an AUC of 0.856 with a 95％CI of(0.72～0.93),indicating a strong predictive capability of the constructed nomogram model for the occurrence of DVT after MED.Bootstrap resampling(1 000 times)validated the nomogram,revealing an average absolute error of 0.016 in the calibration curve and suggesting a good fit with the ideal curve.Clinical decision curves showed that the nomogram model's applicability was optimal for predicting the occurrence of DVT after MED surgery in elderly patients with lumbar disc herniation when the decision threshold ranged from 0.03 to 0.93.Conclusion The independent risk factors affecting the formation of DVT after MED surgery in elderly patients with lumbar disc herniation include elevated D-dimer levels,history of cerebrovascular disease,diabetes,and history of deep vein thrombosis.The nomogram model established based on these risk factors is highly accurate and of high clinical value.
Lumbar disc herniationMicro endoscopic discectomyDeep vein thrombosisPrognosisNomogram model
NETL
NSTL
万方数据
