闭合性Pilon骨折术后下肢深静脉血栓形成的影响因素及其风险预测列线图模型构建
The influencing factors of lower limb deep vein thrombosis after closed Pilon fracture surgery and the construction of risk prediction nomogram model
梁胜凯 1谢磊 1李瑶 1刘佳 2王欣 3刘国峰 4张奉琪3
作者信息
- 1. 050000 河北省石家庄市第三医院骨科
- 2. 河北省石家庄市人民医院麻醉科
- 3. 河北医科大学第三医院骨科
- 4. 河北省邯郸市中心医院骨科
- 折叠
摘要
目的 分析影响闭合性Pilon骨折术后下肢深静脉血栓形成(DVT)的危险因素,并构建列线图预测模型.方法 2019年6月～2022年6月接受外科手术治疗的闭合性Pilon骨折病人182例,根据术后是否发生DVT分为两组,DVT组43例,非DVT组139例,采用单因素和多因素Logistic回归分析筛选影响闭合性Pilon骨折术后下肢DVT的危险因素;采用R软件构建预测闭合性Pilon骨折术后下肢DVT的列线图模型,使用受试者工作特征曲线(ROC)、校准曲线进行列线图模型验证.结果 Logistic回归分析结果显示,糖尿病史、血栓风险评估结果为中高危、手术部位发生术后感染是闭合性Pilon骨折术后下肢DVT的独立危险因素(P＜0.05)o ROC曲线下面积0.716(95％CI:0.629～0.804).校准曲线斜率接近 1,且 H-L 拟合优度检验 x2=2.556,P=0.635.结论 有糖尿病史、血栓风险评估结果为中高危、手术部位有发生术后感染是闭合性Pilon骨折术后下肢DVT的独立危险因素,整合以上3项独立危险因素构建的列线图预测模型能有效预测闭合性Pilon骨折术后下肢DVT,区分度、一致性较高.
Abstract
Objective To analyze the risk factors of lower limb deep vein thrombosis(DVT)after the closed Pilon fracture surgery,and to build a nomograph prediction model.Methods A total of 182 patients with closed Pilon fracture who underwent surgical treatment in our hospital from June 2019 to June 2022 were retrospectively analyzed,according to the occurrence of postoperative DVT,the patients were divided into two groups:43 cases in DVT group and 139 cases in non-DVT group.Univariate and multivariate Logistic regression analysis was applied to screen the risk factors of lower limb DVT after closed Pilon fracture surgery;R software was applied to build a nomograph model for predicting lower limb DVT after closed Pilon fracture surgery,and receiver operating characteristic(ROC)and calibration curve were applied to verify the nomograph model.Results Logistic regression analysis showed that the history of diabetes mellitus,risk assessment of thrombosis as medium and high risk,and postoperative infection were independent risk factors for lower limb DVT after closed Pilon fracture surgery(P＜0.05).The area under the ROC curve was 0.716(95％CI:0.629-0.804).The slope of calibration curve was close to 1,and H-L goodness of fit test x2=2.556,P=0.635.Conclusion The history of diabetes,the result of thrombosis risk assessment as"medium-high risk",and the postoperative infection occurred at the surgical site are independent risk factors for lower limb DVT after closed Pilon fracture surgery.The nomogram prediction model constructed by integrating the above three independent risk factors can effectively predict lower limb DVT after closed Pilon fracture surgery,with high differentiation and consistency.
关键词
闭合性Pilon骨折/术后/肢深静脉血栓形成/危险因素/列线图预测模型Key words
closed Pilon fracture/postoperative/lower limb deep venous thrombosis/risk factors/nomogram prediction model引用本文复制引用
出版年
2024
NETL
NSTL
万方数据