老年髋部骨折术后并发心力衰竭相关因素分析及列线图预测模型构建
Analysis of risk factors for postoperative heart failure after hip fracture in the elderly and construc-tion of nomogram prediction model
王阳 1张卫红 1朱旭1
作者信息
- 1. 郑州大学第一附属医院骨科,郑州 450052
- 折叠
摘要
目的 分析老年髋部骨折患者术后并发心力衰竭的相关危险因素,并构建预测老年髋部骨折术后心力衰竭发生风险的Nomogram模型.方法 选取2020年1月至2023年3月于郑州大学第一附属医院实施手术的607例髋部骨折患者作为研究对象.根据患者术后有无并发急性心力衰竭分为心力衰竭组(n=76)和无心力衰竭组(n=531),分析两组患者的临床资料,采用二元Logistic回归分析确定老年髋部骨折患者术后并发心力衰竭的危险因素.利用R软件构建Nomogram模型,并通过受试者工作特征(ROC)曲线和校准曲线对模型进行评价.结果 年龄[比值比(OR)=1.044,95％可信区间(CI):1.008～1.081]、高血压(OR=2.800,95％CI:1.503～5.217)、冠心病(OR=1.941,95％CI:1.122～3.356)、房颤(OR=4.486,95％CI:2.158～9.323)、血红蛋白浓度(OR=0.964,95％CI:0.943～0.985)、红细胞分布宽度(OR=1.155,95％CI:1.025～1.303)是老年髋部骨折术后并发心力衰竭的危险因素,差异有统计学意义(P＜0.05).根据危险因素构建Nomogram模型,风险预测模型的ROC曲线下面积为0.793(95％CI:0.759～0.825);校准曲线显示该模型的预测风险与实际风险一致.结论 年龄、高血压、冠心病、房颤、血红蛋白浓度、红细胞分布宽度是老年髋部骨折术后并发心力衰竭的危险因素,据此构建的Nomogram模型能有效预测老年髋部骨折患者术后心力衰竭的发病风险.
Abstract
Objective To analyze the risk factors for postoperative heart failure in elderly patients with hip fracture,and to construct a nomogram model for predicting the risk of postoperative heart failure in elderly patients with hip fracture.Methods A total of 607 patients with hip fracture who underwent sur-gery in the First Affiliated Hospital of Zhengzhou University from January 2020 to March 2023 were selected as the research objects.The patients were divided into the heart failure group(n=76)and the non-heart failure group(n=531)according to whether they had acute heart failure after surgery.The clinical data of the two groups were analyzed.Binary Logistic regression analysis was used to determine the risk factors for postoperative heart failure in elderly patients with hip fracture.The R software was used to construct a nomogram model,and the receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the model.Results Age[odds ratio(OR)=1.044,95％confidence interval(CI):1.008-1.081],hypertension(OR=2.800,95％CI:1.503-5.217),coronary heart disease(OR=1.941,95％CI:1.122-3.356),atrial fibrillation(OR=4.486,95％CI:2.158-9.323),hemoglobin concentration(OR=0.964,95％CI:0.943-0.985),and red blood cell distribution width(OR=1.155,95％CI:1.025-1.303)were risk factors for heart failure after hip fracture surgery in the elderly,and the differences were statistically significant(P＜0.05).According to the risk factors,a nomogram model was constructed.The area under the ROC curve of the risk prediction model was 0.793(95％CI:0.759-0.825),indicating that the model had good discrimination.The calibration curve showed that the predicted risk of the model was in good agreement with the actual risk,indicating that the model was well calibrated.Conclusion Age,hypertension,coronary heart disease,atrial fibrillation,hemoglobin concentration and red blood cell distribution width are risk factors for heart failure after hip fracture surgery in the elderly.The nomogram model constructed based on these factors can effectively predict the risk of postoperative heart failure in eld-erly patients with hip fracture.
关键词
老年人/髋部骨折/心力衰竭/危险因素/列线图Key words
Aged/Hip fracture/Heart failure/Risk factors/Nomogram引用本文复制引用
出版年
2024
NETL
NSTL
万方数据