| 窦银娜,王 冰,杜阳红.老年髋关节置换术后应激性高血糖风险预测模型的建立及验证[J].中国烧伤创疡杂志,2024,(3):226~231. |
| DOI： |
| 中文关键词: 髋关节置换 应激性高血糖 Logistic 回归分析 预测模型 应用价值 |
| 英文关键词:Hip replacement Stress hyperglycemia Logistic regression analysis Predictive model Application value |
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| 中文摘要: |
| 【摘要】 目的 建立老年髋关节置换术后应激性高血糖的风险预测模型, 并验证其应用价值。方法 便利抽样法选取 2018 年 3 月至 2023 年 3 月郑州市骨科医院收治的 340 例行髋关节置换术的老年患者作为研究对象,并将其分为建模组 (230 例) 与验证组 (110 例), 收集患者年龄、糖尿病家族史、术后应激性高血糖发生情况等资料, 采用多因素 Logistic 回归分析老年髋关节置换术后并发应激性高血糖的独立危险因素, 根据分析结果建立老年髋关节置换术后应激性高血糖风险预测模型, 并验证模型有效性及预测价值。结果 多因素 Logistic 回归分析结果显示, 年龄>75岁、有焦虑、有抑郁、C反应蛋白>8 mg / L、糖化血红蛋白>6%、有营养风险、营养支持方式为肠外营养、手术持续时间>1.5 h 是老年髋关节置换术后并发应激性高血糖的独立危险因素 (95%CI 为1.200～13.322、1.156～ 3.792、1.205～4.375、1.849～9.444、4.507～22.929、1.135～3.496、1.058～3.084、2.282～21.737, P= 0.024、 P= 0.014、P= 0.011、P= 0.001、P<0.001、P = 0.016、P = 0.030、P = 0.001); 得出预测模型公式为 P= 1 /〔1+exp [- (-3.857+危险因素总分×0.591) ]〕; 受试者操作特征 (ROC) 曲线分析结果显示,曲线下面积为 0.801, 敏感度为 81.2%, 特异度为 74.9%, P<0.01; Hosmer-Lemeshow 卡方检验结果显示, χ2 = 5.235, P= 0.601。结论 预测模型能够预测老年髋关节置换术后应激性高血糖的发生风险, 且具有较高的拟合校正性能以及良好的预测识别能力。 |
| 英文摘要: |
| 【Abstract】 Objective To establish the risk predictive model for stress hyperglycemia after hip replacement in the elderly and validate its application value. Methods 340 elderly patients underwent hip replacement in Zhengzhou Orthopaedics Hospital from March 2018 to March 2023, were selected as research subjects by convenience sampling, and divided into
modeling group (n = 230) and validation group (n = 110). The data of patients’ age, family history of diabetes, and occurrence of postoperative stress hyperglycemia were collected. Multivariate Logistic regression was conducted to analyze the independent risk factors for stress hyperglycemia after hip replacement in the elderly. The risk prediction model for stress
hyperglycemia after hip replacement in the elderly was established according to the analysis results, and the effectiveness and predictive value of the model were validated. Results The results of multivariate Logistic regression analysis showed that, age > 75 years, with anxiety and depression, C-reactive protein > 8 mg / L, glycosylated hemoglobin > 6%, nutritional risk, parenteral nutrition support, and operation duration>1.5 hours were independent risk factors for stress hyperglycemia after hip replacement in the elderly ( 95% CI: 1.200- 13.322, 1.156 - 3.792, 1.205 - 4.375, 1.849 - 9.444, 4.507 -22.929, 1.135-3.496, 1.058-3.084, 2.282-21.737, P = 0.024, P = 0.014, P = 0.011, P = 0.001, P<0.001, P =0.016, P= 0.030, P= 0.001). The predictive model formula was P = 1 / 〔1+exp [ - ( -3.857+ total risk factor score×0.591) ] 〕. The receiver operating characteristic (ROC) curve showed that the area under the curve was 0.801, with the sensitivity being 81.2% and the specificity being 74.9%, P<0.01. The Hosmer-Lemeshow chi-square test result showedχ2 = 5.235, P= 0.601. Conclusion The predictive model can predict the risk of stress hyperglycemia after hip replacement in elderly patients, and has high fitting correction performance and good prediction and recognition ability. |
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