Objective To develop and verify a predictive model for hip fracture risk in the aged patients with knee osteoarthritis(KOA)on the basis of analysis of the risk factors associated with the hip fracture.Methods A retrospective study was conducted to analyze the 701 patients who had been diag-nosed with KOA(Kellgren-Lawrence grades 1 to 4)at Dongyang Hospital affiliated to Wenzhou Medical Uni-versity from September 2013 to September 2023.The cohort consisted of 275 males and 426 females with an age of(76.5±8.4)years.The patients were divided into a fracture group(n=145)and a fracture-free group(n=556)based on whether a hip fracture occurred during the follow-up period.The 2 groups were compared in terms of age,gender,comorbidities,albumin level,absolute lymphocyte count,and Kellgren-Lawrence grade,etc.The items with P＜0.05 were analyzed by a multivariate logistic regression model to identify the risk factors for hip fracture in the aged KOA patients.A clinical prediction model based on the above risk fac-tors was constructed and validated for hip fracture risk in the aged KOA patients.Results Multivariate lo-gistic regression analysis identified the following as independent risk factors for hip fracture in the aged KOA patients:female(OR=2.009,95％CI:1.280 to 3.154,P=0.002),age ≥75 years(OR=2.313,95％CI:1.493 to 3.583,P=0.001),Kellgren-Lawrence grades of 3-4(OR=2.348,95％CI:1.533 to 3.596,P=0.001),an albumin level＜35 g/L(OR=0.316,95％CI:0.191 to 0.522,P=0.001),and an absolute lymphocyte count＜0.8 × 109/L(OR=0.133,95％CI:0.069 to 0.253,P=0.001).The area under the ROC curve(AUC)for the model developed by this study was 0.753 in the training set and 0.815 in the validation set(P＜0.05).The Hosmer-Lemeshow goodness-of-fit test showed that the consistency between the predicted risk and the actual risk was good in the training and validation sets(P＜0.05).The calibra-tion curves for both the training and validation sets closely aligned with the ideal curve.The clinical deci-sion curve analysis showed that the nomogram model had a good net benefit rate and a good predictive po-tential.Conclusions Female,age ≥75 years,Kellgren-Lawrence grades of 3-4,an albumin level＜35 g/L,and an absolute lymphocyte count＜0.8 × 109/L are independent risk factors for hip fracture in the aged KOA patients.Since the nomogram prediction model based on these risk factors is satisfactory in discrimi-nation and calibration,it shows a certain predictive ability and application value in clinic.
关键词
髋骨折/骨关节炎/危险因素/列线图/预测模型
Key words
Hip fractures/Osteoarthritis/Risk factors/Nomogram/Prediction model
维普
万方数据