Construction of nomogram of the risk of poor postoperative pain relief in patients with osteoporotic compression fractures
Objective To analyse risk factors for poor pain relief after percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fractures(OVCF)and to construct a column chart.Methods A total of 136 OVCF patients treated with PVP in our hospital from July 2019 to June 2022 were selected.Poor pain relief and good pain relief were defined according to the difference in visual analogue scales(VAS)of pain at 1 day preoperatively and 1 month postoperatively.Independent risk factors for poor postoperative pain relief in OVCF patients were analyzed by multifactorial logistic regression.Diagnostic ability of independent risk factors was assessed by receiver operating characteristic curve(ROC).Predictive accuracy and net clinical benefit of the column line diagrams were assessed based on independent risk factor column line diagrams and by calibration curve and decision curve analysis.Results There were 58 patients(42.6%)with poor pain relief and 78 patients(57.4%)with good pain relief after PVP.The results of multifactorial logistic regression analysis showed that age,ASA classification(gradeⅢ-Ⅳ),smoking,thoracolumbar fascial injury,bone mineral density(BMD)(T-score),bone cement injection volume,and cement leakage were the independent risk factors for poor pain relief after PVP(P<0.05).Age,ASA classification,smoking,thoracolumbar fascial injury,BMD(T-score),bone cement injection volume and bone cement leakage Area under the curve(AUC)were 0.782,0.604,0.601,0.622,0.743,0.840,and 0.651,respectively.Columnar plots of the risk of poor pain relief after PVP The calibration curve was close to the original and ideal curves,with a C-index of 0.814(95%CI:0.704 to 0.913)and a good model fit.The column-line plots provided a clinically significant net benefit when the predicted risk threshold was 0.08-1.00.Conclusions The nomogram constructed on the basis of age,ASA classification,smoking,thoracolumbar fascial injury,BMD(T-score),bone cement injection volume and cement leakage is effective in quantifying the risk of poor pain relief after PVP in patients with OVCF.
NETL
NSTL
万方数据
维普
