凝血指标对髋部骨折患者血栓形成风险的预测OA
Prediction of thrombosis risk in patients with hip fracture by coagulation index
目的 探讨凝血指标对髋部骨折患者围术期静脉血栓形成风险的预测价值.方法 回顾性纳入 2020 年 2 月至 2022年 12 月收入笔者医院的 160 例髋部骨折患者,采取随机数字表法将其分为训练集(n=112 例)和验证集(n=48 例),进一步根据训练集患者围术期是否发生深静脉血栓(deep vein thrombosis,DVT)划分为发生组和未发生组.使用最小绝对收缩与选择算子(least absolute shrinkage and selection operator,LASSO)选取变量形成LASSO回归模型;绘制受试者操作特征(receiver operating characteristic,ROC)曲线分析模型的预测效能;通过验证集数据实现验证模型的预测效能.结果 训练集与验证集患者性别、年龄等一般及临床资料比较,差异均无统计学意义(P>0.05).训练集内发生组与未发生组患者性别、年龄、骨折至入院时间、体质量指数、D-二聚体、纤维蛋白原、总蛋白、白蛋白、前白蛋白、球蛋白、血红蛋白、血清钙、红细胞体积、白细胞计数、红细胞体积分布宽度、活化部分凝血活酶时间、凝血酶原时间及淋巴细胞比率比较,差异有统计学意义(P<0.05).通过组间相关系数(intraclass correlation coefficient,ICC)与LASSO筛选出 6 个非零系数的最优变量,分别是年龄、体质量指数、D-二聚体、纤维蛋白原、凝血酶原时间及活化部分凝血活酶时间,非零系数依次为 9.104、1.792、1.270、2.447、3.037 及-1.561.结论 年龄、体质量指数、D-二聚体、纤维蛋白原、凝血酶原时间及活化部分凝血活酶时间变量联合形成的LASSO回归模型可作为预测髋部骨折患者围术期DVT形成风险的辅助工具.
Objective To explore the predictive value of coagulation indexes on the risk of venous thrombosis in perioperative period of hip fracture.Methods Totally 160 patients with hip fracture admitted to our hospital from February 2020 to December 2022 were retrospectively included.They were randomly divided into training set(n=112 cases)and verification set(n=48 cases).Further,according to whether deep vein thrombosis(DVT)occurred in the perioperative period,the patients in the training group were further divided into the occurrence group and the non-occurrence group.Use the least absolute shrinkage and selection operator(LASSO)to select variables to form a LASSO regression model.Draw receiver operating characteristic(ROC)curve to analyze the prediction efficiency of the model;The prediction efficiency of the verification model is realized through the verification set data.Results There was no statistically significant difference in gender,age,and other general and clinical data between the training set and the validation set(P>0.05).There were significant differences in sex,age,time from fracture to admission,body mass index,D-dimer,fibrinogen,total protein,albumin,prealbumin,globulin,hemoglobin,serum calcium,red blood cell volume,white blood cell count,red blood cell volume distribution width,activated partial thromboplastin time,prothrombin time and lymphocyte ratio between the patients in the training set(P<0.05).Six optimal variables with non-zero coefficients were selected by intraclass correlation coefficient(ICC)and LASSO,namely age,body mass index,D-dimer,fibrinogen,prothrombin time and activated partial thromboplastin time.The non-zero coefficients were 9.104,1.792,1.270,2.447,3.037 and-1.561 respectively.Conclusion The LASSO regression model formed by the combination of age,body mass index,D-dimer,fibrinogen,prothrombin time and activated partial thromboplastin time variables can serve as an auxiliary tool for predicting the risk of perioperative DVT formation in patients with hip fractures.
郑爱美;吴银生
温州市中西医结合医院创伤骨科,浙江温州 3250001
临床医学
髋部骨折深静脉血栓围手术期最小绝对收缩与选择算子
Hip fractureDeep vein thrombosisPerioperative periodMinimum absolute shrinkage and selection operators
《中国现代医生》 2024 (023)
48-52 / 5
浙江省温州市科学技术局基础性医疗卫生科技项目(Y20210428)
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