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创伤性颈脊髓损伤患者住院期间深静脉血栓形成的列线图预测模型

Nomogram prediction model for DVT in traumatic cervical spinal cord injury patients during hospitalization.

作者信息

Wu Haifeng, Ni Jiyuan, Sun Huixian, Zhang Yaming, Yan Jincheng

机构信息

Department of Orthopedic Surgery, The Third Hospital of Shijiazhuang, Shijiazhuang, 050000, People Republic of China.

Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, People Republic of China.

出版信息

World Neurosurg. 2025 Jul 7:124234. doi: 10.1016/j.wneu.2025.124234.

Abstract

OBJECTIVE

To explore the risk factors of deep venous thrombosis (DVT) in patients with traumatic cervical spinal cord injury(SCI) during hospitalization, and to establish and verify a Nomogram model.

METHODS

A total of 580 patients with traumatic cervical SCI were enrolled in this study.The general information and laboratory indicators of the patients were collected. Duplex ultrasound was used to diagnose the DVT.The general data of the two groups were compared, and logistic regression analysis was performed to identify independent risk factors for DVT. Based on these identified risk factors, a nomogram model was developed. The accuracy and clinical utility of the model were assessed using the area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis.

RESULTS

The independent risk factors for DVT in patients with traumatic cervical SCI were: ASIA grade (P<0.001) and combined craniocerebral injury (P=0.020), NLR (P<0.001), D-dimer (P<0.001). According to the above four independent risk factors, a nomogram model was constructed. The AUC of the nomogram was 0.808 (95%CI=0.754-0.862) in the training cohort and 0.785 (95%CI= 0.668-0.902) in the validation cohort, respectively. It indicates that this model has a good ability to predict the risk of DVT.The calibration curve and decision curve analysis demonstrated that the model exhibited excellent accuracy and clinical effectiveness.

CONCLUSION

The ASIA grade, combined craniocerebral injury, NLR, and D-dimer, represents independent risk factors for DVT in patients with traumatic cervical SCI during hospitalization. Furthermore, the prediction model developed based on these factors demonstrates robust predictive performance.

摘要

目的

探讨创伤性颈脊髓损伤(SCI)患者住院期间发生深静脉血栓形成(DVT)的危险因素,并建立和验证列线图模型。

方法

本研究共纳入580例创伤性颈SCI患者。收集患者的一般资料和实验室指标。采用双功超声诊断DVT。比较两组的一般数据,并进行逻辑回归分析以确定DVT的独立危险因素。基于这些确定的危险因素,建立列线图模型。使用受试者操作特征(ROC)曲线下面积(AUC)、校准曲线和决策曲线分析评估模型的准确性和临床实用性。

结果

创伤性颈SCI患者发生DVT的独立危险因素为:美国脊髓损伤协会(ASIA)分级(P<0.001)、合并颅脑损伤(P=0.020)、中性粒细胞与淋巴细胞比值(NLR)(P<0.001)、D-二聚体(P<0.001)。根据上述四个独立危险因素,构建列线图模型。该列线图在训练队列中的AUC为0.808(95%CI=0.754-0.86),在验证队列中的AUC为0.785(95%CI=0.668-0.902)。这表明该模型具有良好的预测DVT风险的能力。校准曲线和决策曲线分析表明,该模型具有出色的准确性和临床有效性。

结论

ASIA分级、合并颅脑损伤、NLR和D-二聚体是创伤性颈SCI患者住院期间发生DVT的独立危险因素。此外,基于这些因素开发的预测模型具有强大的预测性能。

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