Risk Factors of Lower Extremity Deep Vein Thrombosis After Artificial Femoral Head Replacement for Elderly Femoral Neck Fractures and a Nomogram Model Construction.

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Alternative therapies in health and medicine Pub Date : 2024-08-01

Guoshun Huang, Feng Han, Haifeng Wu, Tao Fan, Weidong Guo

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Abstract

Objective: To assess lower extremity deep vein thrombosis (DVT) risk factors after artificial femoral head replacement for elderly femoral neck fractures. A nomogram model was constructed to predict its risk.

Methods: In analyzing 144 participants who underwent artificial femoral head replacement for elderly femoral neck fractures, researchers collected clinical data to identify factors associated with lower extremity DVT. The study collected numerous variables ranging from age and sex to history of lower extremity DVT and use of anticoagulant drugs after surgery. The patients were in two groups: those who developed DVT (n = 62) and those who did not (n = 82). Multivariate logistic regression analysis helped to identify factors influencing the occurrence of DVT after artificial femoral head replacement. The software packages used were R 4.1.0 and RMS.

Results: Univariate and multivariate regression analysis identified age, ASA level, D-dimer of lower limb DVT, ALB, and PLT as predictive risk factors of lower extremity DVT after artificial femoral head replacement for elderly femoral neck fractures. Those risk factors were used to construct a clinical predictive nomogram. The calibration curves for hypertension in patients with OSAHS risk revealed excellent accuracy of the predictive nomogram model. The unadjusted concordance index (C-index) for the model was 0.877 [95% confidence interval (CI), 0.805-0.942]. The AUC was 0.8375002. Decision curve analysis showed that the predictive model could be applied clinically when the threshold probability was 20 to 80%.

Conclusions: The researchers constructed and validated a clinical nomogram to predict the occurrence of lower extremity DVT after artificial femoral head replacement in elderly patients with femoral neck fractures. Age, ASA level, D-dimer, and history of lower limb DVT, ALB, and PLT were demonstrated to be predictive risk factors of lower extremity DVT in this circumstance. This practical prognostic nomogram may help improve clinical decision-making.

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人工股骨头置换术治疗老年股骨颈骨折后下肢深静脉血栓形成的风险因素及诺记图模型构建。

目的评估老年股骨颈骨折人工股骨头置换术后下肢深静脉血栓形成（DVT）的风险因素。方法：分析 144 名接受老年股骨颈骨折人工股骨头置换术的患者：研究人员对144名因老年股骨颈骨折而接受人工股骨头置换术的患者进行了分析，收集了临床数据，以确定与下肢深静脉血栓相关的因素。研究收集了从年龄、性别到下肢深静脉血栓病史以及术后使用抗凝药物等多个变量。患者分为两组：发生深静脉血栓的患者（62 人）和未发生深静脉血栓的患者（82 人）。多变量逻辑回归分析有助于确定人工股骨头置换术后发生深静脉血栓的影响因素。所用软件包为R 4.1.0和RMS：单变量和多变量回归分析发现，年龄、ASA水平、下肢深静脉血栓的D-二聚体、ALB和PLT是老年股骨颈骨折人工股骨头置换术后下肢深静脉血栓的预测风险因素。这些风险因素被用于构建临床预测提名图。OSAHS风险患者高血压的校准曲线显示，预测提名图模型具有极高的准确性。该模型的未调整一致性指数（C-index）为 0.877 [95% 置信区间 (CI)，0.805-0.942]。AUC为0.8375002。决策曲线分析表明，当阈值概率为 20% 至 80% 时，该预测模型可用于临床：研究人员构建并验证了预测老年股骨颈骨折患者人工股骨头置换术后下肢深静脉血栓发生的临床提名图。在这种情况下，年龄、ASA水平、D-二聚体、下肢深静脉血栓形成史、ALB和PLT被证明是下肢深静脉血栓形成的预测风险因素。这一实用的预后提名图有助于改善临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alternative therapies in health and medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

0.90

自引率

0.00%

发文量

219

期刊介绍： Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field. Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.