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创伤性胸腰椎骨折术后深静脉血栓形成的预测模型的建立与验证。

Development and validation of a predictive model for preoperative deep vein thrombosis following traumatic thoracolumbar fractures.

机构信息

Department of Orthopaedic Surgery, Hebei Medical University Third Hospital, Shijiazhuang, 050051, Hebei, People's Republic of China.

Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.

出版信息

Sci Rep. 2024 Aug 22;14(1):19547. doi: 10.1038/s41598-024-70464-w.

DOI:10.1038/s41598-024-70464-w
PMID:39174790
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11341695/
Abstract

Although a sequential work-up for deep vein thrombosis has reached agreement worldwide, the mysterious nature of DVT following fractures brings challenges to early diagnosis and intervention. The objective of the present study was to develop and validate a nomogram for predicting preoperative DVT risk in patients with thoracolumbar fractures using readily available clinical data. Of the 1350 patients, 930 were randomly assigned to the training cohort. A prediction model was established and visualized as a nomogram based on eight predictors related to preoperative DVT. The performance of the model was tested by the receiver operating characteristic curve, Hosmer-Lemeshow test, calibration curve, and decision curve analysis. We further verified the model in the validation cohort. The AUCs of the prediction model were 0.876 and 0.853 in training and validation cohorts, respectively. The Hosmer-Lemeshow test demonstrated good fitness in the training set (X = 5.913, P = 0.749) and the validation set (X = 9.460, P = 0.396). Calibration and decision curve analyses performed well in training and validation sets. In short, we developed a prediction model for preoperative DVT risk in patients with thoracolumbar fractures and verified its accuracy and clinical utility.

摘要

尽管深静脉血栓形成的序贯检查已在全球范围内达成共识,但骨折后深静脉血栓形成的神秘性质给早期诊断和干预带来了挑战。本研究的目的是开发和验证一种列线图,用于使用易于获得的临床数据预测胸腰椎骨折患者术前深静脉血栓形成的风险。在 1350 名患者中,930 名被随机分配到训练队列。基于与术前 DVT 相关的 8 个预测因子,建立了一种预测模型,并将其可视化作为列线图。通过接收者操作特征曲线、Hosmer-Lemeshow 检验、校准曲线和决策曲线分析来测试模型的性能。我们在验证队列中进一步验证了该模型。预测模型在训练队列和验证队列中的 AUC 分别为 0.876 和 0.853。Hosmer-Lemeshow 检验表明训练集(X=5.913,P=0.749)和验证集(X=9.460,P=0.396)拟合良好。训练集和验证集的校准和决策曲线分析表现良好。总之,我们开发了一种预测胸腰椎骨折患者术前深静脉血栓形成风险的模型,并验证了其准确性和临床实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ad8/11341695/dcbd679cd49c/41598_2024_70464_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ad8/11341695/b118bfe4057d/41598_2024_70464_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ad8/11341695/dcbd679cd49c/41598_2024_70464_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ad8/11341695/b118bfe4057d/41598_2024_70464_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ad8/11341695/dcbd679cd49c/41598_2024_70464_Fig4_HTML.jpg

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