摘要
目的分析老年骨质疏松性胸腰椎压缩骨折患者术后残余腰背痛的影响因素,并构建预测模型。方法选取2019年9月~2022年9月术后残余腰背痛、未发生残余腰背痛的老年骨质疏松性胸腰椎压缩骨折患者各85例(前者为研究组,后者为对照组),收集两组临床资料,采用单因素、多因素Logistic回归分析对术后残余腰背痛的影响因素进行分析,构建预测模型,绘制受试者工作特征曲线(receiver operating characteristic,ROC)分析预测效能。结果合并筋膜损伤、骨密度T值低、骨水泥分布(O型)、短期并发症为患者术后残余腰背痛的独立危险因素,而实施早期康复干预、康复干预依从性良好为保护因素(P<0.05)。构建风险预测模型:Log(P)=2.084×合并筋膜损伤+2.187×骨密度T值+1.793×骨水泥分布+1.796×短期并发症-3.099×实施早期康复干预-3.734×康复干预依从性-27.052,该模型预测老年骨质疏松性胸腰椎压缩骨折术后残余腰背痛的ROC曲线下面积为0.888(95%CI:0.837~0.938,P<0.05);预测模型阈值=16.98时的敏感度、特异度最佳,分别为0.867、0.864;该模型的Hosmer-Lemeshow检验无差异,有较好的符合程度。结论合并筋膜损伤、骨密度T值低、骨水泥分布(O型)、短期并发症,是影响老年骨质疏松性胸腰椎压缩骨折患者术后残余腰背痛的独立危险因素,实施早期康复干预、康复干预依从性良好为保护因素;可据此建立模型进行预测,并开展相应干预措施,减轻患者疼痛。
Objective To analyze the influencing factors for postoperative residual low back pain in elderly patients with osteoporotic thoracolumbar vertebral compression fracture,and establish a prediction model.Methods A total of 85 elderly patients with osteoporotic thoracolumbar compression fracture with postoperative residual low back pain and no residual low back pain were selected from September 2019 to September 2022(the former as the study group and the latter as the control group).Clinical data of the two groups were collected.Univariate analysis and multivariate logistic regression analysis were conducted to identify the influencing factors for postoperative residual low back pain.A prediction model was established,and its predictive performance was analyzed using the receiver operating characteristic(ROC)curve.Results Fascia injury,low T value of bone mineral density,bone cement distribution(type O)and short-term complications were independent risk factors for postoperative residual low back pain,while early rehabilitation intervention and good compliance with rehabilitation intervention were protective factors(P<0.05).The risk prediction model was as follows:Log(P)=2.084×fascia injury+2.187×T value of bone mineral density+1.793×bone cement distribution+1.796×short-term complications-3.099×early rehabilitation intervention-3.734×compliance with rehabilitation intervention-27.052.The area under the ROC curve of this model to predict postoperative residual low back pain in elderly patients with osteoporotic thoracolumbar vertebral compression fracture was 0.888(95%CI:0.837~0.938,P<0.05).The sensitivity and specificity of the model were the best when its threshold value was 16.98,which was 0.867 and 0.864,respectively.Hosmer-Lemeshow test for this model showed no statistically significant difference,with good coincidence.Conclusion Fascia injury,low T value of bone mineral density,bone cement distribution(type O)and short-term complications are independent risk factors for postoperative residual low back pain
作者
周圆圆
张玲敏
袁之木
ZHOU Yuan-yuan;ZHANG Ling-min;YUAN Zhi-mu(Department of Rehabilitation Medicine,Nanjing Tongren Hospital,School of Medicine,Southeast University,Nanjing,Jiangsu 211100,China;Department of Orthopaedics,Nanjing Tongren Hospital,School of Medicine,Southeast University,Nanjing,Jiangsu 211100,China)
出处
《颈腰痛杂志》
2024年第1期101-106,共6页
The Journal of Cervicodynia and Lumbodynia
关键词
老年
骨质疏松
胸腰椎压缩骨折
残余腰背痛
影响因素
预测模型
elderly
osteoporosis
thoracic and lumbar vertebral compression fractures
residual lower back pain
influencing factors
prediction model
