Xu Haining, Tian Jianliang, Li Liang, Liu Fang, Ren Yuebing, Guo Guangming, Peng Qian
Department of Orthopedics, Dongying People's Hospital 317 Dongcheng South 1st Road, Dongying District, Dongying 257091, Shandong, China.
Department of Emergency, Dongying People's Hospital 317 Dongcheng South 1st Road, Dongying District, Dongying 257091, Shandong, China.
Am J Cancer Res. 2024 Jun 15;14(6):2946-2956. doi: 10.62347/VFDM5811. eCollection 2024.
This study focuses on the clinical features affecting the outcome and prognosis of multiple myeloma (MM) associated with spinal fractures. We retrospectively analyzed the clinical data of 194 MM patients with pathologic thoracic or lumbar spine fractures admitted to Dongying People's Hospital from April 2005 to February 2021. Patients were categorized into effective and ineffective groups based on post-treatment pain scores and mobility to analyze the influencing factors on the efficacy. Univariate analysis showed that age ≥60 years, number of vertebral fractures ≥2, and conservative treatment were associated with the outcomes. The number of vertebral fractures ≥2 (OR=2.198, =0.034) and conservative treatment (OR=1.685, =0.012) were identified as independent risk factors. In addition, survival curves were depicted using the Kaplan-Meier method, and independent risk factors affecting 2-year survival included efficacy (HR=17.924, <0.001), age (HR=3.544, =0.003) and International Staging System staging (HR=10.770, =0.001). Finally, we constructed a high-accuracy prognostic model for predicting 2-year survival of MM patients with pathologic fractures (AUC=0.756). In conclusion, this study identified independent risk factors affecting the outcome and survival of MM patients with morbid fractures by systematically analyzing clinical characteristics and constructing a survival prediction model, thus providing effective guideline for clinical treatment.
本研究聚焦于影响多发性骨髓瘤(MM)合并脊柱骨折患者结局及预后的临床特征。我们回顾性分析了2005年4月至2021年2月期间入住东营市人民医院的194例患有病理性胸椎或腰椎骨折的MM患者的临床资料。根据治疗后疼痛评分和活动能力将患者分为有效组和无效组,以分析疗效的影响因素。单因素分析显示,年龄≥60岁、椎体骨折数量≥2处以及保守治疗与结局相关。椎体骨折数量≥2处(OR = 2.198,P = 0.034)和保守治疗(OR = 1.685,P = 0.012)被确定为独立危险因素。此外,采用Kaplan-Meier法绘制生存曲线,影响2年生存的独立危险因素包括疗效(HR = 17.924,P < 0.001)、年龄(HR = 3.544,P = 0.003)和国际分期系统分期(HR = 10.770,P = 0.001)。最后,我们构建了一个用于预测MM病理性骨折患者两年生存率的高精度预后模型(AUC = 0.756)。总之,本研究通过系统分析临床特征并构建生存预测模型,确定了影响MM病理性骨折患者结局和生存的独立危险因素,从而为临床治疗提供了有效的指导原则。