摘要
目的 探讨影响髋部骨折术后并发肺炎的影响因素,并构建风险预测模型,为临床医师尽早识别术后肺炎的高危患者,予以有效干预措施提供科学依据。方法 回顾性收集2020年3月—2023年5月于郑州大学第一附属医院急诊外科就诊的71接受手术治疗的髋部骨折患者基线资料,根据术后30 d内是否并发肺炎分为发生组(18例)与未发生组(53例),比较两组患者的基线资料,采用logistic回归分析检验影响髋部骨折术后并发肺炎的影响因素,同时依据回归结果构建预测模型,并以受试者工作特征曲线(ROC)分析预测模型的应用价值。结果 两组患者在是否合并慢性支气管炎/肺气肿、术前血清白蛋白水平方面比较,差异有统计学意义(P<0.05)。logistic回归性分析检验显示,合并慢性支气管炎/肺气肿、低血清白蛋白水平影响髋部骨折术后并发肺炎的影响因素(P<0.05)。构建风险预测模型,绘制ROC内部验证显示AUC为0.844,AUC的95%CI为0.752~0.937,P<0.001、特异度:0.604,敏感度:0.944,约登指数:0.548;外部验证显示AUC为0.828,AUC的95%CI为0.727~0.928,P<0.001、特异度:0.566,敏感度:0.944,约登指数:0.510。结论 合并慢性支气管炎/肺气肿、血清白蛋白水平是影响髋部骨折患者并发术后肺炎的影响因素,基于上述因素构建的风险预测模型对并发术后肺炎具有中等预测价值。
Objective To explore the influencing factors of postoperative pneumonia in hip fractures and construct a risk prediction model,in order to provide scientific basis for clinical physicians to identify high-risk patients with postopera-tive pneumonia as early as possible and provide effective intervention measures.Methods The baseline data of 71 hip fracture patients who underwent surgery in the Department of Emergency Surgery of the First Affiliated Hospital of Zheng-zhou University from March 2020 to May 2023 were retrospectively collected.According to whether pneumonia occurred within 30 days after surgery,they were divided into an occurrence group(18 cases)and a non occurrence group(53 ca-ses).The baseline data of the two groups were compared.Logistic regression analysis was used to test the influencing factors of pneumonia after hip fracture surgery.At the same time,a prediction model was constructed based on the re-gression results,and the application value of the prediction model was analyzed by receiver operating characteristic curve(ROC).Results There was a statistical significant difference between the two groups in terms of whether they had chronic bronchitis/emphysema and preoperative serum albumin levels(P<0.05).Logistic regression analysis showed that chronic bronchitis/emphysema and low serum albumin level had an impact on the influencing factors of postoperative pneumonia of hip fracture(P<0.05).The risk prediction model was constructed,and ROC internal validation showed that AUC was 0.844,95%CI of AUC was 0.752-0.937,P<0.001,specificity:0.604,sensitivity:0.944,and Youdens J statistic index:0.548.External validation showed that AUC was 0.828,95%CI of AUC was 0.727-0.928,P<0.001,specificity:0.566,sensitivity:0.944,and Youdens J statistic index:0.510.Conclusion Chronic bronchitis/emphysema and serum albumin level are the influencing factors of postoperative pneumonia in hip fracture patients.The risk prediction model based on the above factors has moderate predictive value for postoperative pneumonia.
作者
孟宇
于永魁
孟伟利
柴宇霞
傅兆宇
陈聚伍
王楠
MENG Yu;YU Yong-kui;MENG Wei-li;CHAI Yu-xia;FU Zhao-yu;CHEN Ju-wu;WANG Nan(Department of Emergency Surgery,the First Afiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Thoracic Surgery,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450008,China)
出处
《医药论坛杂志》
2023年第18期5-9,共5页
Journal of Medical Forum
基金
河南省医学科技攻关联合共建项目(LHGJ20220357)。
关键词
髋部骨折
肺炎
预测模型
影响因素
Hip fracture
Pneumonia
Prediction model
Influence factor
