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股骨头置换术后并发症临床预测模型的构建

Construction of a Clinical Prediction Model for Complications After Femoral Head Replacement Surgery.

作者信息

Li Ke Wei, Rong Shuai, Li Hao

机构信息

Pediatric Orthopedics, The Third Hospital of Shijiazhuang, Shijiazhuang City, Hebei Province, China.

出版信息

J Clin Med Res. 2024 Dec;16(11):554-563. doi: 10.14740/jocmr6047. Epub 2024 Nov 11.

Abstract

BACKGROUND

While femoral head replacement is widely used with remarkable efficacy, the complexity and diversity of postoperative complications pose a serious prognostic challenge. There is an urgent need to develop a clinical prediction model that can integrate multiple factors and accurately predict the risk of postoperative complications to guide clinical practice and optimize patient management strategies. This study is dedicated to constructing a postoperative complication prediction model based on statistics and machine learning techniques, in order to provide patients with a safer and more effective treatment experience.

METHODS

A total of 186 patients who underwent femoral head replacement in the Orthopedic Department of our hospital were collected in this study. Forty-two of the patients had at least one postoperative complication, and 144 had no complications. The preoperative and postoperative data of patients were collected separately and medical history was collected to study the correlation factors affecting the occurrence of postoperative complications in patients and to establish a prediction model.

RESULTS

Possibly relevant factors were included in a one-way logistic regression, which included the patient's gender, age, body mass index, preoperative diagnosis of the mode of injury, osteoporosis or lack thereof, as well as medical history, surgical-related information, and laboratory indices. After analyzing the results, it was concluded that operation time, alanine transaminase (ALT), aspartate aminotransferase (AST), white blood cell count, serum albumin, and osteoporosis, were the risk factors affecting the development of complications after femoral head replacement in patients (P < 0.2). The data obtained were further included in a multifactorial regression, and the results showed that operation time, AST, white blood cell count, serum albumin, and osteoporosis were independent risk factors for complications after the patients underwent femoral head replacement (P < 0.05).

CONCLUSION

Based on the results of this study, five factors, including duration of surgery, AST, white blood cell count, serum albumin, and osteoporosis, were identified as independent risk factors for complications after patients underwent femoral head replacement. In addition, the prediction model developed in this study has a high scientific and clinical application value, providing clinicians and patients with an important tool for assessing the risk of complications after affected femoral head replacement.

摘要

背景

虽然股骨头置换术被广泛应用且疗效显著,但术后并发症的复杂性和多样性对预后构成了严峻挑战。迫切需要开发一种临床预测模型,该模型能够整合多种因素并准确预测术后并发症的风险,以指导临床实践并优化患者管理策略。本研究致力于基于统计学和机器学习技术构建术后并发症预测模型,以便为患者提供更安全、有效的治疗体验。

方法

本研究收集了我院骨科行股骨头置换术的186例患者。其中42例患者至少发生了1种术后并发症,144例未发生并发症。分别收集患者术前和术后的数据并采集病史,以研究影响患者术后并发症发生的相关因素并建立预测模型。

结果

将可能相关的因素纳入单因素逻辑回归分析,这些因素包括患者的性别、年龄、体重指数、术前损伤方式诊断、是否存在骨质疏松,以及病史、手术相关信息和实验室指标。分析结果后得出,手术时间、谷丙转氨酶(ALT)、谷草转氨酶(AST)、白细胞计数、血清白蛋白以及骨质疏松是影响患者股骨头置换术后并发症发生的危险因素(P < 0.2)。将获得的数据进一步纳入多因素回归分析,结果显示手术时间、AST、白细胞计数、血清白蛋白和骨质疏松是患者股骨头置换术后并发症的独立危险因素(P < 0.05)。

结论

基于本研究结果,确定手术时长、AST、白细胞计数、血清白蛋白和骨质疏松这5个因素为患者股骨头置换术后并发症的独立危险因素。此外,本研究开发的预测模型具有较高的科学性和临床应用价值,为临床医生和患者评估患侧股骨头置换术后并发症风险提供了重要工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/105e/11614405/44ad47563379/jocmr-16-554-g001.jpg

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