Establishment of a predictive model for the risk of deep vein thrombosis after orthopedic surgery in the lower extremities and its verification
- VernacularTitle:下肢骨科手术后深静脉血栓形成风险的预测模型构建与验证
- Author:
Jiangnan ZHANG
1
;
Ronghua LI
;
Hongmei ZHOU
;
Minyi XU
;
Liangyu CAI
Author Information
- Keywords: orthopedic surgery of lower extremity; deep venous thrombosis; risk prediction model; machine learning; D-dimer; artificial intelligence
- From: Journal of Clinical Medicine in Practice 2023;27(23):73-78
- CountryChina
- Language:Chinese
- Abstract: Objective To construct and validate a predictive model for the risk of deep vein thrombosis(DVT)after lower extremity orthopedic surgery.Methods Clinical records of hospital-ized patients who underwent lower extremity orthopedic surgery in Wuxi Traditional Chinese Medicine Hospital from January 2017 to October 2019 were collected.The univariate and multivariate analysis with the backward stepwise method were applied to screen variables and build a nomogram prediction model,and the performance of the nomogram was evaluated with respect to its discriminant capabili-ty,calibration ability,and clinical utility.Results A total of 5 773 hospitalized patients with ortho-pedic surgery of lower extremity were included in the study,with the incidence of DVT of 0.9％.Through single factor and multi-factor stepwise regression analysis,5 variables were selected from 31 variables to construct the prediction model,including age,mean corpuscular hemoglobin concentra-tion(MCHC),D-dimer,platelet distribution width(PDW),and thrombin time(TT).The receiver operating characteristic(ROC)curve showed that areas under the ROC curve in the training and vali-dation cohort were 0.859 and 0.857,respectively.The model had good calibration ability and clini-cal practicability.Conclusion The DVT risk prediction model constructed in this study has good dif-ferentiation ability,calibration ability and clinical practicability,which is helpful for doctors to classi-fy DVT patients after lower extremity orthopedic surgery and formulate early treatment plan.
