新型风险因素和个性化风险计算器用于预测成年脊柱形手术后近端结点形
Qijun Wang1, Zheng Wang1, Dongfan Wang1
1Department of Orthopedics & Elderly Spinal Surgery, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China.
一个新的风险计算器确定了成年脊柱形 (ASD) 手术后近端结节形 (PJK) 的可修改因素. 该工具有助于个性化风险评估和术后管理,改善患者的治疗结果.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 整形外科 整形外科 整形外科
- 生物医学工程 生物医学工程
背景情况:
- 靠近结节 (PJK) 是成年脊柱形 (ASD) 手术后的一种常见并发症.
- 现有的PJK预测模型缺乏个性化,依赖于不可修改的因素,限制了临床效用.
研究的目的:
- 为了确定PJK的新风险因素.
- 在ASD手术后开发个性化PJK风险计算器.
主要方法:
- 对213名接受重新调整手术的ASD患者进行了回顾性分析.
- 机器学习 (LASSO) 来识别PJK预测器.
- 开发了八个ML模型,并将最佳模型部署为使用SHAP值的个性化风险计算器.
主要成果:
- 在213名患者中,78名患者 (36.6%) 患有PJK.
- 七个临床可修改的特征被确定为关键预测因素,包括骨盆补偿和手术前下肢功能.
- 随机森林模型实现了0.847.7的AUC.
结论:
- 在ASD手术后开发了一种新的PJK在线风险计算器.
- 该计算器使用可修改的临床特征进行个性化风险评估和术后管理指导.
- 建议进行多中心验证,以确认可通用性.
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