The value of nomograph model based on BNP and IL-6 in individualized prediction of the risk of postoperative ad-verse cardiovascular events in elderly hip fracture patients
Objective To explore the value of the nomogram model based on brain natriuretic peptide(BNP)and interleukin-6(IL-6)in the individualized prediction of the risk of postoperative major adverse cardiovascular events(MACE)in elderly hip fracture patients.Methods Two hundred and thirty-four elderly hip fracture patients admitted to author's hospital from January 2016 to December 2022 were included as the modeling set,while 253 elderly hip fracture patients ad-mitted to orthopedics department of the Sixth Affiliated Hospital of Xinjiang Medical University were included as the valida-tion set.Elderly hip fracture patients in the validation set who experienced MACE within 30 days after surgery were divided into the MACE group of 37 cases(15.8%)and the N-MACE group of 197 cases(84.2%).The general clinical data,laborato-ry indicators,left ventricular ejection fraction and surgery related indicators of patients between the two groups in the mod-eling set were compared,the statistically significant variables in the single factor analysis were included in the multivariate Logistic regression analysis to obtain the independent predictors of MACE in elderly hip fracture patients after surgery,the analysis was focused on the predictive value of BNP and IL-6,and a nomogram model was constructed,calibration curve and ROC curve were drawn to further analyze the predictive performance and accuracy of the nomogram model.Results Multivariate Logistic regression analysis adjusted for confounding factors,ASA grade,age,BNP and IL-6 were still inde-pendent predictors of postoperative MACE in elderly hip fracture patients[OR(95%)CI=2.576(1.243-4.567),2.317(1.237-4.347),2.467(1.214-3.598),2.389(1.208-3.672),P＜0.05];A nomograph modelwas constructed to predict the risk of post-operative MACE in elderly hip fracture patients based on four independent predictors:ASA grade,age,BNP and IL-6;The calibration curve showed that the predicted value of postoperative MACE risk of elderly hip fracture patients in the model-ing set and the validation set were in good agreement with the actual observation value(P＞0.05).The ROC analysis results showed that the area under the curve(AUC)of jointly prediction in the modeling set was 0.923(95%CI0.882-0.967),and the AUC of jointly prediction in the validation set was 0.903(95%CI0.876-0.958).Conclusion The nomograph model based on BNP and IL-6 can be used to accurately predict the risk of postoperative MACE in elderly hip fracture patients.
Hip fractureBrain natriuretic peptideInterleukin-6Major adverse cardiovascular eventsNomogramElderly
维普
万方数据
