The Construction of a Predictive Model for Postoperative Hip Dislocation in Patients Undergoing Total Hip Arthroplasty Based on Nomogram
Objective To analyze the risk of hip dislocation in patients undergoing total hip arthroplasty(THA)and construct a predictive model for hip dislocation based on the nomogram.Methods With the selection of 180 THA patients admitted to the hospital from January 2022 to November 2023 as the research subjects,patients were divided into dislocation group and non-dislocation group according to whether hip dislocation occurred after operation.With the analysis of risk factors for hip dislocation in THA patients after surgery through univariate and multivariate Logistic regression,a predictive model for hip dislocation in THA patients after surgery was constructed based on this.The discriminative power of the prediction model was evaluated using receiver operating characteristic(ROC)curves,the calibration of the prediction model was evaluated using Hosmer-Lemeshow goodness of fit method,and the clinical applicability of the prediction model was evaluated using clinical decision curve analysis(DCA).Results Among 180 THA patients,28 patients experienced hip dislocation after surgery,with an incidence rate of 15.56％.The results of univariate analysis showed that age,hip surgery history,prosthesis diameter,prosthesis placement position,postoperative position control,and surgical approach were related to the occurrence of hip dislocation after operation in the dislocation group and the non dislocation group(P＜0.05);The results of multiple Logistic regression analysis showed that age,history of hip surgery,prosthesis placed outside the safe zone,inadequate postoperative position control,and posterolateral approach were all risk factors for hip dislocation in THA patients after surgery(OR＞1,P＜0.05).The area under the ROC curve(AUC)of the predictive model was 0.895(95％CI was 0.823～0.968),with an optimal sensitivity of 0.750 and specificity of 0.901,indicating that the predictive model can effectively distinguish the risk of hip dislocation in THA patients after surgery;The test results of Hosmer-Lemeshow goodness of fit method showed that the calibration of the prediction model was good(P=0.077);The DCA analysis results showed that the predictive model had good clinical applicability.Conclusion With good discrimination,calibration,and clinical applicability,the prediction model for postoperative hip dislocation in THA patients based on nomogram can provide a theoretical basis for early prediction,prevention,and treatment of hip dislocation in clinical practice.
NomogramTotal hip arthroplastyHip dislocationPrediction model
万方数据
维普
