Risk factors and prediction model construction for postoperative anemia in elderly patients undergoing knee replacement
Objective To explore the risk factors of postoperative anemia in elderly patients undergoing knee re-placement and construct the predictive model.Methods A total of 229 older patients who underwent knee replacement from October 2021 to August 2023 in Qilu Hospital of Shandong University were selected and divided into anemia group and no anemia group according to whether they were anaemic after surgery.Lasso regression analyses and logistic regres-sion analyses were used to identify independent risk factors for postoperative anemia,and the prediction model was con-structed and its accuracy was evaluated.Results Lasso regression and multivariate logistic regression suggested that moderate frailty(OR=5.195,95%CI:1.462-18.456,P=0.011),preoperative anemia(OR=21.754,95%CI:2.680-176.608,P=0.027),and abnormal BUN(OR=3.021,95%CI:1.214-7.518,P=0.017)were risk factors for postopera-tive anemia.A nomogram was established based on these factors.ROC curve indicated that the prediction model had good discrimination,and AUC was 0.714(95%CI:0.644-0.785).The calibration curve confirmed a good consistency be-tween the model prediction results and the actual observations.DCA showed that when the risk threshold of postoperative anemia was 0.18-0.74,the use of this nomograph in the current study was more clinically valuable.Conclusions Mod-erate frailty,preoperative anemia,and abnormal BUN are the influence factors for postoperative anemia of knee replace-ment.The clinical prediction model based on these factors has a certain predictive value for postoperative anemia.
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