Tan Xiu-Juan, Gu Xiao-Xia, Ge Feng-Min, Li Zhi-Yi, Zhang Liang-Qing
Department of Anesthesiology, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China.
Department of Anesthesiology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China.
World J Clin Cases. 2022 Apr 26;10(12):3720-3728. doi: 10.12998/wjcc.v10.i12.3720.
By analyzing the risk factors of postoperative complications in elderly patients with hip replacement, We aimed to develop a nomogram model based on preoperative and intraoperative variables and verified the sensitivity and specificity for risk stratification of postoperative complications in elderly with total hip replacement patients.
To develop a nomogram model for risk stratification of postoperative complications in elderly with total hip replacement patients.
A total of 414 elderly patients who underwent surgical treatment for total hip replacement hospitalized at the Affiliated Hospital of Guangdong Medical University from March 1, 2017 to August 31, 2019 were included into this study. Univariate and multivariate logistic regression were conducted to identify independent risk factors of postoperative complication in the 414 patients. A nomogram was developed by R software and validated to predict the risk of postoperative complications.
Multivariate logistic regression analysis revealed that age (OR = 1.05, 95%CI: 1.00-1.09), renal failure (OR = 0.90, 95%CI: 0.83-0.97), Type 2 diabetes (OR = 1.05, 95%CI: 1.00-1.09), albumin (ALB) (OR = 0.91, 95%CI: 0.83-0.99) were independent risk factors of postoperative complication in elderly patients with hip replacement ( < 0.05). For validation of the nomogram, receive operating characteristic curve revealed that the model predicting postoperative complication in elderly patients with hip replacement was the area under the curve of 0.8254 (95%CI: 0.78-0.87), the slope of the calibration plot was close to 1 and the model passed Hosmer-Lemeshow goodness of fit test ( = 10.16, = 0.4264), calibration in R E = 0.176, E = 0.027, which all demonstrated that the model was of good accuracy.
The nomogram predicting postoperative complications in patients with total hip replacement constructed based on age, type 2 diabetes, renal failure and ALB is of good discrimination and accuracy, which was of clinical significance.
通过分析老年髋关节置换患者术后并发症的危险因素，我们旨在基于术前和术中变量建立一个列线图模型，并验证其对老年全髋关节置换患者术后并发症风险分层的敏感性和特异性。
建立老年全髋关节置换患者术后并发症风险分层的列线图模型。
纳入2017年3月1日至2019年8月31日在广东医科大学附属医院住院接受全髋关节置换手术治疗的414例老年患者。对这414例患者进行单因素和多因素logistic回归分析，以确定术后并发症的独立危险因素。用R软件建立列线图并验证其预测术后并发症的风险。
多因素logistic回归分析显示，年龄（OR = 1.05，95%CI：1.00 - 1.09）、肾衰竭（OR = 0.90，95%CI：0.83 - 0.97）、2型糖尿病（OR = 1.05，95%CI：1.00 - 1.09）、白蛋白（ALB）（OR = 0.91，95%CI：0.83 - 0.99）是老年髋关节置换患者术后并发症的独立危险因素（P < 0.05）。为验证列线图，受试者工作特征曲线显示，预测老年髋关节置换患者术后并发症的模型曲线下面积为0.8254（95%CI：0.78 - 0.87），校准曲线斜率接近1，且模型通过了Hosmer-Lemeshow拟合优度检验（χ² = 10.16，P = 0.4264），R中的校准E = 0.176，E = 0.027，均表明该模型具有良好的准确性。
基于年龄、2型糖尿病、肾衰竭和ALB构建的全髋关节置换患者术后并发症预测列线图具有良好的区分度和准确性，具有临床意义。
