同济大学学报（医学版）2026，Vol.47Issue(2)：246-254,9.DOI:10.12289/j.issn.2097-4345.25249
基于贝叶斯网络的股骨颈骨折内固定术后股骨头坏死风险预测
Prediction of osteonecrosis of femoral head after internal fixation for femoral neck fracture using Bayesian networks
摘要
Abstract
Objective To construct a risk prediction model using a Bayesian network(BN)to predict osteonecrosis of femoral head(ONFH)after internal fixation for femoral neck fracture(FNF),facilitating the visualization and uncertainty interpretation of the model.Methods Using retrospective data from patients admitted to three hospitals in Shanghai for FNF and undergoing internal fixation surgery,an analysis and modeling were conducted.A total of 24 variables were included,including demographic characteristics,blood biochemical indicators,and surgery-related factors.Two machine learning algorithms were used for feature engineering,and a BN was used to build the model.The five-fold cross-validation was used to evaluate model performance and clinical applicability based on the area under the receiver operating characteristic curve(AUROC),sensitivity,specificity,F1 index,and decision curve analysis(DCA).Results The rate of the ONFH after internal fixation of FNF was 22％,and the BN model showed that complete weight-bearing time,visual analogue scale(VAS)score of pain,Harris hip score,reduction quality,injury-to-operation time,femoral neck shortening,and Garden classification were the direct influencing factors,while body mass index(BMI)and osteoporosis were indirect influencing factors.The AUROC,sensitivity,specificity,and F1 index of the model under the five-fold cross-validation was 0.931,0.927,0.921 and 0.922,respectively.BN model inference could provide a probabilistic explanation of outcomes.Conclusion The BN model has good performance and clinical applicability,which can visualize the direct and indirect influencing factors of ONFH and improve the uncertainty interpretation ability through probability inference.关键词
股骨颈骨折/股骨头坏死/贝叶斯网络/概率推断/预测模型Key words
femoral neck fracture/osteonecrosis of femoral head/Bayesian network/probabilistic inference/prediction models分类
医药卫生引用本文复制引用
汤心怡,刘粤,杨巾夏,郑嘉祺,艾自胜..基于贝叶斯网络的股骨颈骨折内固定术后股骨头坏死风险预测[J].同济大学学报（医学版）,2026,47(2):246-254,9.基金项目
上海市卫生健康委员会科研项目(202340144) （202340144）
