沈阳医学院学报2026，Vol.28Issue(1)：24-29,6.DOI:10.16753/j.cnki.1008-2344.2026.01.005
构建老年患者胸腰椎椎体成形术后运动恐惧症的风险预测模型
Construction of a risk prediction model for kinesiophobia after thoracolumbar vertebroplasty in elderly patients
摘要
Abstract
Objective:To analyze the influencing factors of kinesiophobia in elderly patients after thoracolumbar vertebroplasty and construct a nomogram model for predicting the risk of kinesiophobia.Methods:The clinical data of 196 elderly patients who underwent thoracolumbar vertebroplasty from Dec 2021 to Dec 2024 in our hospital were retrospectively analyzed.They were divided into kinesiophobia group(n=138)and non-kinesiophobia group(n=58)according to the score of Treadmill Scale for Kinesiophobia(TSK).LASSO regression was used to screen potential predictive variables,and multivariate logistic regression was used to analyze factors influencing the occurrence of kinesiophobia.A predictive nomogram was constructed based on these influencing factors,followed by internal validation and performance evaluation.The model's discriminatory ability was assessed using the area under the receiver operating characteristic(ROC)curve.The predictive accuracy was evaluated via calibration curves,model goodness-of-fit was examined through the Hosmer-Lemeshow test,and clinical net benefit was analyzed using decision curve analysis.Results:LASSO regression results showed that four factors were screened as potential influencing factors for kinesiophobia in elderly patients after thoracolumbar vertebroplasty.Muitivariate logistic regression analysis showed that VAS score(OR=1.568,95%CI:1.320-1.818),GAD-2 score(OR=1.145,95%CI:1.013-1.398),PHQ-2 score(OR=1.402,95%CI:1.272-1.763),and SSRS score(OR=0.325,95%CI:0.183-0.575)were influencing factors for the occurrence of kinesiophobia(P＜0.05).According to the ROC curve analysis,the obtained AUC was 0.995(95%CI:0.971-0.999),indicating good discriminative ability.The goodness-of-fit test of the calibration curve showed good calibration(χ2=0.321,P=0.997＞0.05).The decision curve analysis showed that the model's thresholds of＞0.04 provided higher net clinical benefits than the VAS score,GAD-2 score,PHQ-2 score,and SSRS score.Conclusion:The prediction model based on VAS score,GAD-2 score,PHQ-2 score,and SSRS score demonstrates good predictive ability,which can help to guide the individualized intervention for kinesiophobia after thoracolumbar vertebroplasty in elderly patients.关键词
胸腰椎椎体成形术/运动恐惧症/列线图Key words
thoracolumbar vertebroplasty/kinesiophobia/nomogram分类
医药卫生引用本文复制引用
李文..构建老年患者胸腰椎椎体成形术后运动恐惧症的风险预测模型[J].沈阳医学院学报,2026,28(1):24-29,6.基金项目
江西省卫生计生委科技计划项目(No.20197333) （No.20197333）
