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构建并验证全膝关节置换术后下肢深静脉血栓形成的预测模型。

Construction and validation of a predictive model for lower extremity deep vein thrombosis after total knee arthroplasty.

机构信息

Ya'an Hospital of Traditional Chinese Medicine.

出版信息

Medicine (Baltimore). 2024 Jun 14;103(24):e38517. doi: 10.1097/MD.0000000000038517.

Abstract

The aim was to investigate the independent risk factors for lower extremity deep vein thrombosis (DVT) after total knee arthroplasty, and to establish a nomogram prediction model accordingly. Data were collected from total knee replacement patients from January 2022 to December 2023 in our hospital. Unifactorial and multifactorial logistic regression analyses were used to determine the independent risk factors for lower extremity DVT after total knee arthroplasty and to establish the corresponding nomogram. The receiver operating characteristic curves were plotted and the area under the curve was calculated, and the calibration curves and decision curves were plotted to evaluate the model performance. A total of 652 patients with total knee arthroplasty were included in the study, and 142 patients after total knee arthroplasty developed deep veins in the lower extremities, with an incidence rate of 21.78%. After univariate and multivariate logistic regression analyses, a total of 5 variables were identified as independent risk factors for lower extremity DVT after total knee arthroplasty: age > 60 years (OR: 1.70; 95% CI: 1.23-3.91), obesity (OR: 1.51; 95% CI: 1.10-1.96), diabetes mellitus (OR: 1.80; 95% CI: 1.23-2.46), D-dimer > 0.5 mg/L (OR: 1.47; 95% CI: 1.07-1.78), and prolonged postoperative bed rest (OR: 1.64; 95% CI: 1.15-3.44). the nomogram constructed in this study for lower extremity DVT after total knee arthroplasty has good predictive accuracy, which helps physicians to intervene in advance in patients at high risk of lower extremity DVT after total knee arthroplasty.

摘要

目的在于探究全膝关节置换术后下肢深静脉血栓(DVT)的独立危险因素,并据此建立列线图预测模型。数据收集自 2022 年 1 月至 2023 年 12 月在我院行全膝关节置换术的患者。采用单因素和多因素 logistic 回归分析确定全膝关节置换术后下肢 DVT 的独立危险因素,并建立相应的列线图。绘制受试者工作特征曲线并计算曲线下面积,绘制校准曲线和决策曲线以评估模型性能。本研究共纳入 652 例全膝关节置换术患者,术后发生下肢深静脉血栓 142 例,发生率为 21.78%。单因素和多因素 logistic 回归分析后,共确定 5 个变量为全膝关节置换术后下肢 DVT 的独立危险因素:年龄>60 岁(OR:1.70;95%CI:1.23-3.91)、肥胖(OR:1.51;95%CI:1.10-1.96)、糖尿病(OR:1.80;95%CI:1.23-2.46)、D-二聚体>0.5mg/L(OR:1.47;95%CI:1.07-1.78)、术后卧床时间延长(OR:1.64;95%CI:1.15-3.44)。本研究构建的全膝关节置换术后下肢 DVT 列线图具有良好的预测准确性,有助于医师对全膝关节置换术后下肢 DVT 高危患者进行提前干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fecb/11175919/5dc752ab8b34/medi-103-e38517-g001.jpg

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