Department of Ultrasound Medicine, Baoding No.1 Central Hospital, Baoding, 071000, People's Republic of China.
Department of Orthopaedic Surgery, Baoding No.1 Central Hospital, 320 Changcheng North Street, Baoding, 071000, Hebei, People's Republic of China.
Arch Orthop Trauma Surg. 2024 Jan;144(1):171-177. doi: 10.1007/s00402-023-05085-5. Epub 2023 Oct 4.
Deep venous thrombosis (DVT) is a common complication in patients with spinal fractures caused by high-energy injuries. Early identification of patients at high risk of postoperative DVT is essential for the prevention of thrombosis. This study aimed to develop and validate a prediction model based on a nomogram to predict DVT in patients with spinal fractures caused by high-energy injuries.
Clinical data were collected from 936 patients admitted to our hospital between January 2016 and December 2021 with spinal fractures caused by high-energy injuries. Multivariate logistic regression analysis was used to identify the risk factors for postoperative DVT and to develop a nomogram. The predictive performance of the nomogram was evaluated by the receiver operating characteristic (ROC) curve and calibration curve.
The incidence of preoperative DVT was 15.38% (144/936). The postoperative incidence of DVT was 20.5% (192/936). The multivariate analysis revealed that age, operation time, blood transfusion, duration of bed rest, American Spinal Injury Association (ASIA) score and D-dimer were risk factors for postoperative DVT. The area under the ROC curve of the nomogram was 0.835 and the calibration curve showed good calibration.
The nomogram showed a good ability to predict postoperative DVT in patients with spinal fractures caused by high-energy injuries, which may benefit pre- and postoperative DVT prophylaxis strategy development.
深静脉血栓(DVT)是高能损伤所致脊柱骨折患者的常见并发症。早期识别术后发生 DVT 高危患者对于预防血栓形成至关重要。本研究旨在开发和验证一种基于列线图的预测模型,以预测高能损伤所致脊柱骨折患者的 DVT。
收集了 2016 年 1 月至 2021 年 12 月期间我院收治的 936 例高能损伤所致脊柱骨折患者的临床资料。采用多变量 logistic 回归分析确定术后 DVT 的危险因素,并构建列线图。通过接受者操作特征(ROC)曲线和校准曲线评估列线图的预测性能。
术前 DVT 的发生率为 15.38%(144/936)。术后 DVT 的发生率为 20.5%(192/936)。多因素分析显示,年龄、手术时间、输血、卧床时间、美国脊髓损伤协会(ASIA)评分和 D-二聚体是术后 DVT 的危险因素。列线图的 ROC 曲线下面积为 0.835,校准曲线显示良好的校准度。
列线图在预测高能损伤所致脊柱骨折患者术后 DVT 方面具有良好的能力,可能有助于制定术前和术后 DVT 预防策略。