摘要
目的监测髋部骨折患者手术前后的营养水平,并基于营养相关指标构建不良预后风险模型,探讨其模型的预测效能。方法选取2020年2月—2022年2月于浙江中医药大学附属温州市中医院骨科接受治疗的172例髋骨骨折患者作为研究对象,根据随访结果将其分为生存组和死亡组,对比2组患者的营养相关指标,并采用logistic回归分析构建髋部骨折患者不良预后的风险模型,通过ROC曲线分析评估该模型的预测效能。结果截至末次随访时间,共失访3例患者,51例患者死亡纳入死亡组,118例纳入生存组。多因素logistic回归分析显示,年龄增加、血红蛋白、白蛋白、前白蛋白以及血肌酐水平降低均是髋部骨折患者出现不良预后的独立危险因素(P<0.05);ROC曲线显示,联合预测(AUC=0.989,灵敏度为94.1%,特异度为96.6%,准确率为95.86%)的预测效能高于单项指标的预测效能。结论基于四者营养相关指标构建的不良预后风险模型对预测髋部骨折患者死亡的发生具有良好的诊断效能。
Objective Based on the nutrition-related indexes of patients with hip fracture,a risk model of poor prognosis was established and its predictive efficiency was analyzed.Methods From February 2020 to February 2022,a total of 172 patients with hip fracture who were treated in the Department of Orthopaedics,Wenzhou TCM Hospital of Zhejiang Chinese Medical University were selected as the research objects.According to the follow-up results,they were divided into survival group and death group.The nutritional related indexes of the two groups were compared.Logistic regression analysis was used to build a risk model for predicting poor prognosis of patients with hip fracture,and ROC curve analysis was conducted to evaluate the predictive efficiency of the model.Results Up to the last follow-up time,3 patients were lost,51 patients died and were included in death group,118 patients were included in the survival group.Multivariate logistic regression showed that increasing age and reducing hemoglobin,albumin,prealbumin levels and decreasing serum creatinine were independent risk factors for poor prognosis in patients with hip fracture(P<0.05).The ROC curve demonstrated that the joint prediction had higher predictive efficiency(AUC=0.989,sensitivity was 94.1%,specificity was 96.6%,accuracy was 95.86%)compared to single index.Conclusion The risk model based on the four nutritional indicators has good diagnostic efficiency in predicting the mortality of patients with hip fracture.
作者
黄一笑
周雪来
王永乐
张魁贤
HUANG Yixiao;ZHOU Xuelai;WANG Yongle;ZHANG Kuixian(Department of Orthopedics and Traumatology,Wenzhou TCM Hospital of Zhejiang Chinese Medical University,Wenzhou,Zhejiang 325000,China)
出处
《中华全科医学》
2024年第8期1340-1343,共4页
Chinese Journal of General Practice
基金
浙江省中医药科技计划项目(2024ZL990)。
