Chinese Journal of Tissue Engineering Research ›› 2024, Vol. 28 ›› Issue (36): 5785-5792.doi: 10.12307/2024.681
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Wang Haotian1, Wu Mao1, 2, Yang Junfeng2, Shao Yang2, Li Shaoshuo2, Yin Heng1, 2, Yu Hao2, Wang Guopeng1, Tang Zhi1, Zhou Chengwei1, Wang Jianwei1, 2
Received:
2023-09-13
Accepted:
2023-11-17
Online:
2024-12-28
Published:
2024-02-27
Contact:
Wang Jianwei, MD, Chief physician, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China; Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Wuxi 214071, Jiangsu Province, China
About author:
Wang Haotian, Master candidate, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Supported by:
CLC Number:
Wang Haotian, Wu Mao, Yang Junfeng, Shao Yang, Li Shaoshuo, Yin Heng, Yu Hao, Wang Guopeng, Tang Zhi, Zhou Chengwei, Wang Jianwei. Postoperative pulmonary infection in elderly patients with hip fracture: construction of a nomogram model for influencing factors and risk prediction[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(36): 5785-5792.
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2.3 术后肺部感染的单因素分析 纳入训练集的305 例患者中,术后肺部无感染组277例(占90.82%),肺部感染组28例(感染率9.18%)。对两组患者临床资料的单因素分析结果见表1,两组实验室检查指标的单因素分析结果见表2。结果显示,两组患者的年龄、性别、受伤至手术时间、卧床时间、手术时长、吸烟史、饮酒史、术前是否存在心血管疾病、白细胞、红细胞、血红蛋白、红细胞压积、平均血红蛋白含量、平均血红蛋白浓度、血小板分布宽度、超敏C-反应蛋白(hypersensitive C-reactive protein,Hs-CRP)、钠、谷草转氨酶、乳酸脱氢酶、果糖胺水平比较差异有显著性意义(P < 0.05);两组在手术方式、麻醉方式、骨折类型、体质量指数、高血压、糖尿病、脑血管疾病等基础疾病以及其他血化验检查结果方面比较,差异无显著性意义(P > 0.05)。"
2.8 老年髋部骨折患者术后肺部感染列线图模型的验证 训练集中联合模型AUC为 0.882(95%CI值为0.819-0.944),截断值(cut off)值为 (0.931,0.714),见图5A,均有统计学意义(P < 0.05)。C-index是综合模型区分能力和一致性的指标,R统计得出C-index为0.88,C-index与AUC一致,该模型区分度良好,具有较高的诊断预测价值。运用R语言绘制出的列线图模型校准曲线,大致位于斜率为1的标准曲线与可接受线之间,贴合度较好,则说明该列线图预测髋部骨折老年患者术后并发肺部感染的风险与实际发生风险一致性良好,模型预测能力良好(图5B)。验证集AUC值为0.851(图6A),列线图C-index及训练集、验证集AUC值均> 0.70,表明模型预测准确度较高。同时,以Bootstrap(B=1 000)进行重复抽样以检验预后模型的校准度,校准曲线显示该列线图预测患者肺部感染与临床实际肺部感染相比有良好的一致性,表明该模型的拟合度较好(图6B)。"
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