医学信息2025，Vol.38Issue(20)：16-20,5.DOI:10.3969/j.issn.1006-1959.2025.20.003
PFNA内固定术治疗老年股骨粗隆间骨折患者疗效的影响因素分析及预测模型构建
Analysis of Influencing Factors and Prediction Model Construction of PFNA Internal Fixation in the Treatment of Elderly Patients with Intertrochanteric Fracture
摘要
Abstract
Objective To explore the influencing factors of the efficacy of proximal femoral nail antirotation(PFNA)internal fixation in the treatment of elderly patients with intertrochanteric fracture,and to construct a prediction model.Methods From January 2021 to May 2024,60 elderly patients with intertrochanteric fracture admitted to Jishui County People's Hospital were selected as the research objects.All patients were treated with PFNA and the therapeutic effect was evaluated by Harris scale of hip joint at 3 months after operation.According to the evaluation results,they were divided into excellent group(n=47)and general group(n=13).The medical records of the two groups were reviewed,and the possible influencing factors of PFNA efficacy were analyzed.Based on the multi-factor results,the construction of the nomogram prediction model was completed,and the effectiveness of the constructed model was analyzed.The calibration curve was drawn,and the calibration degree of the model was verified by Bootstrap method.Results There was no significant difference in age,operation time,operation time,anemia,long-term bed rest before operation and postoperative complications between the two groups(P＞0.05).There were significant differences in ASA classification,osteoporosis,overweight,fracture stability,early postoperative functional exercise and intraoperative needle insertion between the two groups(P＜0.05).Multivariate logistic regression analysis showed that ASA classification,osteoporosis,overweight,fracture stability,early postoperative functional exercise and intraoperative needle insertion were the influencing factors of PFNA treatment effect in elderly patients with intertrochanteric fracture(P＜0.05).According to multivariate analysis,the final formula was obtained:Z=ASA grade×4.280+osteoporosis×4.482+10.089×overweight+fracture stability×6.231+intraoperative needle insertion method×4.246-early intraoperative functional exercise×4.710-10.291,and the nomogram prediction model was constructed.The results showed that the ASA score was 76 scores,osteoporosis was 80 scores,fracture stability was 71 scores,overweight was 72 scores,intraoperative needle insertion method was 75 scores,and early postoperative functional exercise was 70 scores.ROC curve analysis showed that the area under curve was 0.817(95%CI:0.759-0.871).The Bootstrap method was selected to verify the constructed nomogram model,C-index=0.875,and the calibration and standard curve had good fitting degree and good consistency.Conclusion ASA classification,osteoporosis,overweight,fracture stability,early postoperative functional exercise and intraoperative needle insertion method are the influencing factors of PFNA treatment effect in elderly patients with intertrochanteric fracture.The predictive model based on the above factors has a good predictive effect on the therapeutic effect of PFNA internal fixation.关键词
PFNA内固定术/老年股骨粗隆间骨折/预测模型Key words
PFNA internal fixation/Intertrochanteric fracture/Prediction model分类
医药卫生引用本文复制引用
李赣兵,刘世洪,肖凯敏,李伶俐,孙建红..PFNA内固定术治疗老年股骨粗隆间骨折患者疗效的影响因素分析及预测模型构建[J].医学信息,2025,38(20):16-20,5.基金项目
江西省吉安市指导性科技计划项目(编号:20244-049416) （编号:20244-049416）
