长春中医药大学学报2025，Vol.41Issue(3)：318-322,5.DOI:10.13463/j.cnki.cczyy.2025.03.019
全髋关节置换术患者术后输血的列线图风险预测模型的构建
Construction of a nomogram-based risk prediction model for postoperative blood transfusion in patients undergoing total hip arthroplasty
摘要
Abstract
Objective To explore the influencing factors of postoperative blood transfusion in patients undergoing total hip arthroplasty(THA)and to construct a nomogram-based risk prediction model.Methods A retrospective analysis was conducted on the clinical data of 360 THA patients admitted to the Department of Orthopedics in Kailuan General Hospital from January 2022 to June 2024.The dataset was randomly divided into a training set(252 cases)and a test set(108 cases)according to a ratio of 7:3.Univariate and multivariate logistic regression analysis on the training set case data to screen for independent influencing factors of postoperative blood transfusion in THA patients were performed.A nomogram was created using R software,and the model was validated with the test set samples.The model's discrimination was evaluated using the concordance index(C-index),and calibration was assessed using a calibration plot.Results Out of 360 THA patients,78(21.7％)received postoperative blood transfusions.Univariate and multivariate logistic regression analysis showed that comorbidity with hypertension,hemoglobin levels,intraoperative blood loss,and 24-hour postoperative blood calcium were the best predictive factors for postoperative blood transfusions in THA patients.The C-index of the prediction model was 0.818,with specificity and sensitivity of 78.1％and 78.2％,respectively.C-index verified externally was 0.803,and the deviation correction curve in the calibration plot had a high degree of overlap with the ideal curve,indicating good model calibration.Conclusion The risk prediction model for postoperative blood transfusion in THA patients constructed in this study has good discrimination and calibration,which can provide reference for clinical assessment of postoperative blood transfusion risk,development of personalized treatment plans,and improvement of surgical safety.关键词
全髋关节置换术/输血/影响因素/预测模型Key words
total hip arthroplasty/blood transfusion/influencing factor/prediction model分类
医药卫生引用本文复制引用
田烨,张磊,刘志奎,张楠..全髋关节置换术患者术后输血的列线图风险预测模型的构建[J].长春中医药大学学报,2025,41(3):318-322,5.基金项目
河北省2024年度医学科学研究课题计划(20241449) （20241449）
