Analysis of risk factors for lower extremity deep venous thrombosis in patients with type C pelvic fracture patients after internal fixation and construction of related nomogram model
10.3969/j.issn.1671-8348.2023.23.011
- VernacularTitle:C型骨盆骨折患者内固定术后下肢深静脉血栓形成危险因素分析及相关列线图模型的构建
- Author:
Xuefeng LUO
1
;
Zhifei YI
;
Zengru XIE
Author Information
1. 新疆医科大学第一附属医院创伤骨科,乌鲁木齐 830000
- Keywords:
tumor necrosis factor-α;
nomograph model;
type C pelvic fracture;
lower limb deep venous thrombosis
- From:
Chongqing Medicine
2023;52(23):3583-3588,3593
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of lower extremity deep venous thrombosis(DVT)after internal fixation in patients with type C pelvic fracture,and to establish a relevent nomogram model.Methods Atotal of 217 patients with type C pelvic fractures who were admitted to the Orthopedic Center of the hospital from January 2018 to January 2022 were included in the study.All patients underwent internal fixation.According to whether DVT of the lower extremities was formed after operation,they were divided into the DVT group and the non-DVT group(N-DVT).The general clinical data and preoperative in-flammatory factor expression levels of the two groups was compared.Multivariate analysis was used to obtain independent predictors of DVT formation after internal fixation in patients with type C pelvic fractures.The correlation between preoperative inflammatory factors and DVT formation after internal fixation in patients with type C pelvic fractures was analyzed.The relevant nomograph model was constructed,and the Bootstrap method and calibration curve were used to verify the nomograph model internally.The ROC curve and deci-sion curve for predicting DVT formation after internal fixation in patients with type C pelvic fracture were drawn,and the predictive efficiency and net rate of return of independent prediction and combined prediction were an-alyzed.Results Multivariate analysis showed that age,diabetes,preoperative tumor necrosis factor-α(TNF-α),traction and braking,and bed rest time were independent predictors of DVT formation after internal fixa-tion in patients with type C pelvic fractures(P＜0.05).A nomograph model was constructed based on inde-pendent predictors to predict the formation of DVT after internal fixation in patients with type C pelvic frac-ture,and the C index of the distinguishing evaluation index of the nomogram model was 0.834(95％CI:0.812-0.924),the results of goodness of fit(H-L)test showed that the predicted value of DVT formation probability after internal fixation in patients with type C pelvic fracture was in good agreement with the actual observed value(P＞0.05).ROC curve analysis and decision curve analysis showed that age,diabetes,TNF-α,traction and braking,bed rest time and combined prediction model had good predictive performance and net yield in predicting DVT formation after internal fixation in patients with type C pelvic fracture.Conclusion Age,diabetes,TNF-α,traction braking and bed rest time are independent predictors of DVT formation after internal fixation in pa-tients with type C pelvic fracture.The nomogram model based on the above independent predictors has a high value in predicting DVT formation after internal fixation in patients with type C pelvic fracture.
