实用临床医药杂志2026，Vol.30Issue(16)：26-31,39,7.DOI:10.7619/jcmp.20261310
老年骨盆骨折合并多发伤患者静脉血栓栓塞症发生风险的列线图预测模型构建及验证
Construction and validation of a nomogram prediction model for risk of venous thromboembolism in elderly patients with pelvic fractures complicated with multiple injuries
摘要
Abstract
Objective To construct a nomogram model for predicting venous thromboembolism(VTE)in elderly patients with pelvic fractures complicated with multiple injuries and verify its clinical predictive performance.Methods A retrospective analysis was performed on the clinical data of 300 elderly patients with pelvic fractures complicated with multiple injuries in Jiangning Hospital Affiliated to Nanjing Medical University from January 2020 to December 2025.Clinical data of all patients were collected.A multivariate Logistic regression model was used to analyze and screen the influencing fac-tors for VTE in patients.A nomogram risk prediction model for VTE was constructed,and the estab-lished model was validated based on calibration curves and receiver operating characteristic(ROC)curves.Results Among the 300 included patients,102 cases(34.00％)developed VTE(VTE group).The patients without VTE were inclued in non-VTE group.Compared with the non-VTE group,the VTE group had higher age,higher proportion of patients with a history of VTE,higher Injury Severity Score(ISS),higher preoperative D-dimer(D-D)level,longer time from fracture to opera-tion,and longer length of hospital stay,with all differences being statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that age,history of VTE,ISS,time from fracture to operation,length of hospital stay,and preoperative D-D level were all influencing factors for the occurrence of VTE in patients(P＜0.05).The nomogram model constructed based on these influencing factors had a total score ranging from 18 to 286 points,corresponding to a risk range of 0.10 to 0.80,and a higher score indicated a higher risk of VTE.ROC curve evaluation showed that this prediction model performed excellently in judging the occurrence of VTE in elderly patients with pelvic fractures complicated with multiple injuries,with an area under the curve(AUC)of 0.923(95％CI,0.886 to 0.950),a sensitivity of 95.10％,a specificity of 83.33％,and a Youden in-dex of 0.784.After internal validation by the Bootstrap method,the calibration curve showed that the predicted curve was highly consistent with the actual curve(Hosmer-Lemeshowx2=0.746,P=0.584),indicating that both the discrimination and calibration of the model performed well.Con-clusion The influencing factors for VTE in elderly patients with pelvic fractures complicated with multiple injuries include age,ISS,history of VTE,time from fracture to operation,length of hospi-tal stay,and preoperative D-D level.The risk prediction model constructed based on the above in-fluencing factors has high predictive performance for the occurrence of VTE.关键词
骨盆骨折/多发伤/静脉血栓栓塞症/深静脉血栓形成/肺栓塞/损伤严重度评分/列线图模型/预测效能Key words
pelvic fracture/multiple injuries/venous thromboembolism/deep vein thrombo-sis/pulmonary embolism/injury severity score/nomogram model/predictive performance分类
医药卫生引用本文复制引用
陈雨薇,刘敏,魏芳玲,朱晓光..老年骨盆骨折合并多发伤患者静脉血栓栓塞症发生风险的列线图预测模型构建及验证[J].实用临床医药杂志,2026,30(16):26-31,39,7.基金项目
江苏省科技项目(BL2020140) （BL2020140）
