使用诺米图谱预测一年术后死亡风险的老年患者的部骨折
Cheng-Yi Wu1,2, Ching-Fang Tsai3, Hsin-Yi Yang4
1Department of Orthopedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
Scientific reports
|July 8, 2023
概括
这项研究开发了一种临床名录,用于预测关节骨折手术后的一年死亡率. 该模型识别了高风险的老年患者,有助于改善术后护理和降低死亡率.
科学领域:
- 老年医学 老年医学
- 外科手术的结果
- 生物统计学 生物统计学
背景情况:
- 部骨折手术在老年人中很常见,具有显著的死亡风险.
- 目前对死亡风险因素的研究缺乏可靠的预测模型.
- 准确预测一年死亡率对于患者管理至关重要.
研究的目的:
- 确定部骨折患者的一年术后死亡率的关键预测因素.
- 开发和验证用于预测这种死亡率的临床名谱.
- 为了针对性干预,将患者分为不同的风险组.
主要方法:
- 使用迪特曼森研究数据库 (DRD) 对2333名患者 (年龄≥50).
- 雇佣最小绝对缩小和选择运算符 (LASSO) 考克斯回归用于预测器选择.
- 构建并评估了一个名图,包括卡普兰-梅尔风险分层分析.
主要成果:
- 一年内全因死亡率为11.74% (274/2333名患者).
- 确定了关键预测因素:年龄,性别,停留时间,红细胞输血,血红蛋白,血小板计数和eGFR.
- 诺米图实现了一年死亡率预测的AUC为0.717,风险组之间存在显著差异 (p < 0.001).
结论:
- 一个经过验证的诺姆图有效地预测了关节骨折患者的一年术后死亡率.
- 该模型有助于临床医生识别高风险个体进行主动管理.
- 这种工具可以改善老年人骨折护理的结果和资源配置.
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