摘要
目的探讨股骨颈骨折全髋关节置换围手术期输血的危险因素,构建预测此类患者行全髋关节置换围手术期输血风险的列线图模型。方法纳入自2013-09—2019-05行全髋关节置换术的692例老年股骨颈骨折,127例纳入输血组,565例纳入未输血组,输血率18.35%。多因素Logistic回归模型确定围手术期输血的独立危险因素,然后采用R软件构建股骨颈骨折全髋关节置换围手术期输血的列线图模型并绘制ROC曲线评估列线图模型的区分度。结果多因素Logistic回归分析结果显示,手术时间、术中使用氨甲环酸、术前血红蛋白水平是预测股骨颈骨折患者全髋关节置换围手术期输血的独立危险因素。通过R软件制作列线图模型预测股骨颈骨折患者全髋关节置换围手术期输血的ROC曲线(AUC为0.769),表明该模型具有较好的区分度,预测的输血风险与实际发生风险一致性良好。结论基于手术时间、术前血红蛋白水平、术中使用氨甲环酸这3项独立危险因素构建的预测股骨颈骨折患者全髋关节置换围手术期输血风险的列线图模型具有良好的区分度与准确度,为临床医师鉴别输血高风险患者提供指导意义。
Objective To explore the risk factors of perioperative blood transfusion for patients with femoral neck fractures undergoing total hip arthroplasty and construct a nomogram model to predict the risk of perioperative blood transfusion for total hip arthroplasty.Methods A total of 692 patients with femoral neck fractures who underwent total hip arthroplasty from September 2013 to May 2019 were collected.One hundred and twenty-seven cases were included in the blood transfusion group,565 cases were included in the non-transfusion group,the blood transfusion rate was 18.35%.Multivariate Logistic regression model determined the independent risk factors of perioperative blood transfusion.R software was used to construct a perioperative blood transfusion model for femoral neck fracture and total hip arthroplasty and ROC curve was drawn to evaluate the degree of differentiation of the nomogram model.Results Multivariate logistic regression analysis showed that operation time,intraoperative use of tranexamic acid,and preoperative hemoglobin level were independent risk factors for predicting perioperative blood transfusion in patients with femoral neck fractures.A nomogram model constructed with R software to predict the ROC curve of perioperative blood transfusion for patients with femoral neck fracture undergoing total hip arthroplasty(AUC was 0.769)showed that the model had a good degree of discrimination,and the predicted blood transfusion risk was in good agreement with the actual risk.Conclusion The nomogram model constructed based on the three independent risk factors of operation time,preoperative hemoglobin level,and intraoperative use of tranexamic acid to predict the perioperative blood transfusion risk of total hip arthroplasty in patients with femoral neck fractures has good discrimination and accuracy degree,providing guidance for clinicians to identify high-risk patients with blood transfusion.
作者
沈瑞
孟祥英
于腾波
田惠妃
徐奎帅
刘论
SHEN Rui;MENG Xiang-ying;YU Teng-bo;TIAN Hui-fei;XU Kui-shuai;LIU Lun(Department of Orthopedics,the Affiliated Hospital of Qingdao University,Qingdao,Shandong 266000,China;不详)
出处
《中国骨与关节损伤杂志》
2020年第10期1016-1019,共4页
Chinese Journal of Bone and Joint Injury
关键词
股骨颈骨折
全髋关节置换术
输血
列线图
Femoral neck fracture
Total hip arthroplasty
Blood transfusion
Nomogram
