Construction of a predictive model for postoperative pulmonary infection in elderly patients with femoral neck fractures
OBJECTIVE To explore the construction and application of predictive model for postoperative pulmonary infection in elderly patients with femoral neck fracture.METHODS A cohort comprising 192 elderly patients with femoral neck fractures,who underwent treatment at the joint surgery department of Wenzhou Hospital of Inte-grated Traditional Chinese and Western Medicine between Sep 2019 and Jun 2022 were recruited.Patients'demo-graphics including gender,age and education level,American society of anesthesiologists classification,surgical approach,time from injury to surgery,duration of mechanical ventilation,intraoperative blood loss,preoperative basic diseases(diabetes,hypertension,hyperlipidemia,coronary heart disease,chronic obstructive pulmonary dis-ease and anemia),NIH Stroke Scale score,consciousness disorders,swallowing disorders,injury mechanism,hypoalbuminemia,length of hospital stay,body mass index,smoking history,alcohol consumption history,Gar-den classification of fractures,and anti-osteoporosis treatment were collected.Based on postoperative pulmonary infection status,patients were divided into the pulmonary infection group(n=40)and non-pulmonary infection group(n=152).Baseline data of patients were screened by univariate analysis.Multivariate logistic regression a-nalysis was applied to identify the independent risk factors for postoperative pulmonary infection,and a predictive model for pulmonary infection was established.RESULTS Multivariate logistic regression analysis showed that chronic lung disease,Garden classification,NIHSS score,and duration of mechanical ventilation were the risk fac-tors for the a postoperative pulmonary infection in elderly patients with femoral neck fractures(P＜0.05).The lo-gistic regression model was formulated as logit(P)=-0.619+0.231XGarden classification+0.409XNIHSS score+0.513 Xmechanical ventilation+0.641 Xchronic lung disease.CONCLUSION Pulmonary infections in elderly patients with femoral neck fractures are influenced by many factors,in which chronic lung disease,NIHSS score,and the duration of me-chanical ventilation are the risk factors.Corresponding preventive measures should be made in clinical practice to reduce postoperative pulmonary infection and improve the overall quality of life for individuals with femoral neck fracture.
The elderlyFemoral neck fracturePulmonary infectionRisk factorPredictive model
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