摘要
目的基于回归分析预测法构建下肢骨折手术患者并发下肢深静脉血栓(DVT)的风险预测模型,并检验其预测效果。方法选择2019年1月-2021年1月我院收治的下肢骨折手术患者200例,采用一般资料问卷对患者临床资料进行整理,统计DVT发生例数;采用单因素分析、多因素Logistic回归分析下肢骨折术后并发DVT的危险因素,基于回归分析预测法构建风险预测模型,检验模型预测效果。结果200例下肢骨折手术患者中并发DVT 21例,发生率为10.50%;多因素Logistic回归分析结果显示,下肢骨折手术患者并发DVT的独立危险因素为年龄≥60岁、合并糖尿病、BMI≥24kg/m^(2)、血清ALB<35 g/L、PLT>262×109/L、受伤至入院时间≥2d、术后2d D-二聚体≥0.5mg/L(P<0.05);Hosmer-Lemeshow卡方检验显示,DVT风险预测模型具有较好拟合度(χ^(2)=3.467,P=0.063);ROC曲线分析结果显示,ROC曲线下面积为0.786,敏感度为0.822,特异度为0.644,最大约登指数为0.466,临床应用验证准确率为88.75%。结论下肢骨折手术患者术后伴有DVT发生风险,且其危险因素涉及多方面,本研究基于回归分析法构建的风险预测模型灵敏度、特异度表现出色,能实现对DVT风险的准确预测。
Objective To construct a risk prediction model for lower extremity deep vein thrombosis in patients with lower extremity fracture surgery based on the regression analysis prediction method,and to test its prediction effect.Methods A total of 200 patients with lower extremity fractures who were admitted to our hospital from January 2019 to January 2021were selected,and the clinical data of the patients were sorted out with the help of general data questionnaires.Factor analysis and multivariate logistic regression analysis were used to screen the risk factors of lower extremity deep vein thrombosis in patients with lower extremity fracture surgery.Based on the regression analysis prediction method,a risk prediction model was constructed,and the ROC curve analysis and application analysis were used to test the prediction effect of the model.Results According to statistics,there were 21 patients complicated with DVT,and the incidence rate was 10.50%.Univariate analysis and multivariate logistic regression analysis showed that the independent risk factors for DVT in patients with lower extremity fracture surgery were age≥60 years old,complicated with diabetes mellitus,BMI≥24kg/m^(2),serum ALB<35 g/L,PLT>262×10^(9)/L,time from injury to admission≥2d,D-dimer≥0.5mg/L 2d after operation(P<0.05);Hosmer-Lemeshow chi-quare test showed that the DVT risk prediction model had a good fit(χ^(2)=3.467,P=0.063),ROC curve analysis showed that the ROC The area under the curve was 0.786,the sensitivity was 0.822,the specificity was 0.644,the maximum Youden index was 0.466,and the clinical application verification accuracy rate was 88.75%.Conclusions:Patients with lower extremity fractures are at risk of DVT after surgery,and the risk factors involve many aspects.The risk prediction model based on regression analysis has excellent sensitivity and specificity.It can achieve the accurate risk of DVT in the lower extremity,and it is worthy of clinical value.
作者
何燕
刘彐娜
HE Yan;LIU Xuena(Orthopaedics Department,the Second People's Hospital of Wuxi,Wuxi 214000)
出处
《临床护理杂志》
2022年第4期5-9,共5页
Journal of Clinical Nursing
关键词
下肢骨折手术
下肢深静脉血栓
风险预测模型
lower limb fracture surgery
deep venous thrombosis
risk prediction model
