一项回顾性队列研究：合并冠心病的老年髋部骨折患者术后心力衰竭的特征及Nomogram预测模型的构建

IF 3.6 3区医学

Clinical Interventions in Aging Pub Date : 2024-04-08 DOI:10.2147/cia.s450590

Saidi Ran, Zhiqian Wang, Mingming Fu, Zhiyong Hou

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引用次数: 0

摘要

导言：老年合并冠心病（CHD）患者在髋部骨折术后发生急性心力衰竭（AHF）的情况较为常见，本研究旨在探讨老年髋部骨折患者术后发生AHF的危险因素，并构建提名图预测模型：我们回顾性收集了2017年1月至2021年12月在河北医科大学第三医院接受髋部骨折手术的患有CHD的老年髋部骨折患者。我们将其分为训练集和验证集。我们收集了人口统计学数据、实验室指标和影像学检查结果。我们确定了术后 AHF 的风险因素，并使用 R 语言软件建立了提名图预测模型，绘制了 ROC 曲线、校准曲线和 DCA 决策曲线：我们回顾性地收集了 1288 名患有心脏病的老年髋部骨折患者。在排除了 214 名不符合标准的患者后，我们将 1074 名患者纳入研究，并将其分为训练集和验证集。在训练集中，共有 346 例（42.8%）患者在术后出现 AHF。通过单变量和多变量逻辑回归分析，我们确定了术后 AHF 的风险因素，并构建了一个提名图预测模型。预测模型的 AUC 为 0.778。校正曲线显示该模型具有良好的一致性。决策曲线分析表明，该模型具有良好的临床实用性：结论：42.8%的老年合并心脏病患者术后出现 AHF。其中，骨折类型、年龄、入院时贫血、合并慢性阻塞性肺病、ASA ≥ 3、术前等待时间 > 3 天是术后 AHF 的危险因素。我们构建了一个提名图预测模型，该模型可有效预测合并冠心病的老年髋部骨折患者术后AHF的风险。关键词：冠心病急性心力衰竭髋部骨折心血管疾病

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Characteristics of Postoperative Heart Failure in Older Hip Fractures Patients Combined with Coronary Heart Disease and Construction of a Prediction Model of Nomogram, a Retrospective Cohort Study

Introduction: Older patients combined with coronary heart disease (CHD) develop acute heart failure (AHF) after hip fracture surgery is common, and this study aimed to investigate the risk factors of postoperative AHF in older hip fracture patients and to construct a nomogram prediction model.
Methods: We retrospectively collected older hip fracture patients with CHD who underwent hip fracture surgery at the Third Hospital of Hebei Medical University from January 2017 to December 2021. We divided them into a training set and a validation set. We collected the demographic data, laboratory indicators and imaging examination results. We identified risk factors for postoperative AHF and used R language software to establish a nomogram prediction model, plot ROC curves, calibration curves and DCA decision curves.
Results: We retrospectively collected 1288 older hip fractures patients with CHD. After excluding 214 patients who did not meet the criteria, 1074 patients were included in our research and we divided them into the training set and the validation set. In the training set, a total of 346 (42.8%) patients developing postoperative AHF. Through univariate and multivariate logistic regression analysis, we identified the risk factors for postoperative AHF and constructed a nomogram prediction model. The AUC of the prediction model is 0.778. The correction curve shows that the model has good consistency. The decision curve analysis shows that the model has good clinical practicality.
Conclusion: There were 42.8% older patients combined with CHD develop postoperative AHF. Among them, fracture type, age, anemia at admission, combined with COPD, ASA ≥ 3, and preoperative waiting time > 3 days are risk factors for postoperative AHF. We constructed a nomogram prediction model that can effectively predict the risk of postoperative AHF in older hip fracture patients combined with CHD.

Keywords: coronary heart disease, acute heart failure, Hip fracture, cardiovascular disease

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来源期刊

Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-

CiteScore

6.20

自引率

2.80%

发文量

193

期刊介绍： Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.