Analysis of Risk Factors and Forecasting Model Construction of Joint Dislocation after Total Hip Arthroplasty
Objective:To analyze the risk factors of joint dislocation after total hip arthroplasty(THA)and construct a nomograms forecasting model.Method:A total of 184 patients who underwent THA in Ganzhou Hospital of Traditional Chinese Medicine from January 2021 to July 2022 were selected as the study objects.Patients were followed up for 3 months after surgery and were divided into dislocation group(n=26)and non-dislocation group(n=158)according to whether they had hip dislocation.The general data of patients were compared,and the best cut-off value of statistically significant measurement data were obtained by receiver-operating characteristic(ROC)curve.The independent risk factors of joint dislocation after THA were analyzed by logistic multiple regression model and a forecasting model for joint dislocation after THA was constructed.The internal verification of the forecasting model was verified by calibration curve,and the prediction efficiency of the nomograms model was evaluated by decision curve.Result:Compared with the non-dislocation group,patients in the dislocation group were older,had higher body mass index(BMI)and the proportions of prosthesis diameter＜30 mm,postlateral approach,had hip joint surgical history,less strict postoperative position control and prosthesis placed outside of safety zone were higher(P＜0.05).ROC curve analysis results showed that the AUC values of age and BMI respectively was 0.819 and 0.729,and the best cut-off values respectively was 68 years old and 25.1 kg/m2.Age＞68 years old,had hip joint surgical history,prosthesis diameter＜30 mm,postlateral approach,less strict postoperative position control and prosthesis placed outside of safety zone were the risk factors for joint dislocation after THA(P＜0.05).For the prediction of joint dislocation after THA,the C-index of the nomogram model was 0.732[95%CI(0.663,0.846)],has a good agreement between the observed and predicted values.The threshold＞0.19 of the nomogram model,and the clinical net benefits provided by the model were higher than that of the risk factors.Conclusion:This study constructs a nomograms forecasting model for predicting joint dislocation after THA based on age,hip joint surgical history,prosthesis diameter,surgical approach,postoperative position control,and prosthesis placement position.This model has good predictive value for joint dislocation after THA and can identify high risk patients with joint dislocation after THA.
Toral hip arthroplastyJoint dislocationForecasting modelRisk factors
国家科技期刊平台
NSTL
万方数据
维普
