Influencing factors of postoperative pulmonary infections in elderly patients with hip fracture and construction of a nomogram prediction model
Objective To investigate the influencing factors of postoperative pulmonary infections in elderly patients with hip fracture,and to predict the risk of postoperative pulmonary infections in elderly patients with hip fracture by constructing a nomogram based on the influencing factors.Methods A total of 521 elderly hip fracture patients who underwent surgery in the Trauma Orthopedics Department of Zheng-zhou Orthopedics Hospital Affiliated to Henan University,from January 2020 to May 2023 were selected.Clinical data of the patients were recorded,and the patients were randomly divided into a training group(n=417)and a validation group(n=104)by the random number table method.In the training group,in-fluencing factors for postoperative pulmonary infections in elderly hip fracture patients were determined through univariate analysis and multivariate Logistic regression analysis.A nomogram of the risk prediction model was constructed,and the receiver operating characteristic(ROC)curves and calibration curves were drawn in both the training and validation groups to assess the predictive model.Results Among the 521 cases of hip fracture patients included,there were 169 males and 352 females.The results of the multivari-ate Logistic regression analysis showed that advanced age[odds ratio(OR)=1.066,95％confidence in-terval(CI):1.015-1.121],red blood cell distribution width(OR=1.484,95％CI:1.190-1.849),al-bumin(OR=0.899,95％CI:0.825-0.979),C-reactive protein(OR=1.010,95％CI:1.003-1.016),chronic obstructive pulmonary disease(OR=4.531,95％CI:2.050-10.017)were influencing factors for postoperative pulmonary infections in elderly hip fracture patients,with statistically significant differences(P＜0.05).A nomogram was constructed based on these influencing factors,and the areas under the ROC curves for the training group and validation group were 0.869(95％CI:0.833-0.900)and 0.884(95％CI:0.806-0.939),respectively.The calibration curve showed good consistency between predicted risk and the actual incidence of pulmonary infections.Conclusion Advanced age,red blood cell distribu-tion width,albumin,C-reactive protein,and chronic obstructive pulmonary disease are influencing factors for postoperative pulmonary infections in elderly hip fracture patients.The predictive model established based on these factors has reliable predictive value.
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