| 苑家敏,白金,赵树华,等.老年全髋关节置换术后认知功能障碍的危险因素及列线图预测模型构建[J].安徽医药,2022,26(5):991-994. |
| 老年全髋关节置换术后认知功能障碍的危险因素及列线图预测模型构建 |
| Risk factors analysis and nomogram prediction model construction of postoperative cognitive dysfunction of total hip arthroplasty in the elderly |
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| DOI：10.3969/j.issn.1009-6469.2022.05.033 |
| 中文关键词: 关节成形术，置换，髋 认知功能障碍 危险因素 列线图预测 老年人 |
| 英文关键词: Arthroplasty,replacement,hip Cognitive dysfunction Risk factors Nomogram prediction Aged |
| 基金项目:河南省高等学校重点科研项目计划(17A320053) |
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| 中文摘要: |
| 目的通过分析老年全髋关节置换术后认知功能障碍(POCD)发生的相关危险因素，建立并评估个体化预测老年全髋关节置换术后POCD发生风险的列线图模型。方法选取2017年5月至2019年12月郑州大学附属郑州中心医院收治的行全髋关节置换术的老年病人180例作为研究对象，并根据病人术后是否发生POCD 将研究对象分为POCD 组(n=63例)和非POCD组(n=117例)。采用logistic回归模型，分析老年全髋关节置换术后POCD发生的独立危险因素。应用列线图在线网站绘制预测老年全髋关节置换术后POCD发生风险的列线图模型。采用研究对象工作特征曲线(ROC)、校准曲线及Hosmer-Lemeshow拟合优度检验评估列线图模型进行验证。结果年龄、高血压、糖尿病、术前抑郁、颈动脉中重度狭窄及受教育程度为高中以下是老年全髋关节置换术后POCD发生的独立危险因素(P<0.05)。ROC结果显示，预测老年全髋关节置换术后POCD 发生风险的AUC为0.836。校准曲线为斜率接近为1的直线，Hosmer-Lemeshow 拟合优度检验χ2=10.41，P=0.237。结论基于年龄、高血压、糖尿病、术前抑郁、颈动脉中重度狭窄及受教育程度为高中以下6项老年全髋关节置换术后POCD发生的独立影响因素构建的列线图预测模型，区分度与准确度均良好。 |
| 英文摘要: |
| Objective To analyze the risk factors of postoperative cognitive dysfunction (POCD) after total hip arthroplasty in the el?derly, and to establish and evaluate an individual nomogram model for predicting the risk of POCD after total hip arthroplasty in the el?derly.Methods A total of 180 elderly patients with total hip arthroplasty in Zhengzhou Central Hospital Affiliated to Zhengzhou Uni?versity from May 2017 to December 2019 were selected as the research objects, and the subjects were assigned into POCD group (n=63cases) and non POCD group (n=117 cases) according to whether POCD occurred after operation. Logistic regression model was used to analyze the independent risk factors of POCD after total hip arthroplasty in the elderly. A nomogram model was developed on the online website to predict the risk of POCD after total hip arthroplasty in the elderly. Receiver operating characteristic curve (ROC), calibration curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the nomogram model.Results Age, hypertension, diabetes,preoperative depression, moderate and severe carotid stenosis and education level below senior high school were independent risk fac?tors for POCD after total hip arthroplasty in the elderly (P<0.05). ROC results showed that the AUC for predicting the risk of POCD af?ter total hip replacement was 0.836. The calibration curve was a straight line with slope close to 1, and Hosmer-Lemeshow goodness-offit test showed χ2=10.41, P=0.237.Conclusion In this study, based on the six independent influencing factors of POCD after total hip arthroplasty in the elderly of age, hypertension, diabetes mellitus, preoperative depression, moderate to severe carotid stenosis and edu?cation level below senior high school, the nomogram model has good discrimination and accuracy. |
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