开发和验证老年骨科手术90天并发症预测模型:一个多中心前性研究
Doudou Li1, Yanmei Ning2, Ting Zhang1
1Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China.
Archives of gerontology and geriatrics
|February 6, 2026
概括
一个新的预测模型准确地评估了接受骨科手术的老年人手术后并发症的风险. 该工具有助于进行手术前风险评估,并改善患者管理,以便更好地做出临床决策.
科学领域:
- 老年医学 老年医学
- 整形外科手术 整形外科手术
- 医疗信息学 医疗信息学
- 预测建模预测建模
背景情况:
- 由于人口老龄化,老年骨科手术的需求日益增加.
- 老年手术患者手术后并发症的升级率.
- 需要改善老年人手术前风险评估工具.
研究的目的:
- 在老年骨科手术患者中构建术后并发症的预测模型.
- 用老年综合评估数据和手术风险因素来预测风险.
- 评估老年人手术后三个月内出现并发症的风险.
主要方法:
- 前性队列研究,培训/内部验证分为7:3.
- 使用LASSO回归进行变量选择;使用后勤回归进行模型开发.
- 在四个额外的中心进行外部验证;通过AUC,校准图和决策曲线分析 (DCA) 评估性能.
主要成果:
- 模型包含六个关键变量:脆弱性,营养,ADL,麻醉,手术复杂性和手术持续时间.
- 诺莫格拉姆模型的AUC为0.816 (训练),0.791 (内部验证) 和0.789 (外部验证).
- 校准图和DCA证实了所有数据集的良好预测性能.
结论:
- 开发的预测模型有效地识别了老年骨科手术患者短期术后并发症的风险.
- 该模型支持加强手术前风险分层和患者管理.
- 通过这种预测工具的应用,预计会改善临床决策和患者的结果.
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