Analysis of factors related to quality of life in patients undergoing total knee arthroplasty at 6 months af-ter surgery and construction of a nomogram prediction model
10.3969/j.issn.1001-1242.2025.09.012
- VernacularTitle:全膝关节置换术患者术后6个月生活质量的影响因素分析及列线图预测模型的构建
- Author:
Tianyang XING
1
;
Yali LIU
;
Bin YU
Author Information
1. 青岛市市立医院神经康复科,山东省 青岛市,266000
- Publication Type:Journal Article
- Keywords:
total knee arthroplasty;
knee osteoarthritis;
quality of life;
prediction model;
nomogram
- From:
Chinese Journal of Rehabilitation Medicine
2025;40(9):1366-1372
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of quality of life(QoL)being below normal levels in patients undergo-ing total knee arthroplasty(TKA)at 6 months after surgery,and to construct a nomogram prediction model.Method:Two-hundred and sixty-seven patients who underwent TKA at Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital)from April 2021 to October 2022 were selected.Clini-cal data were collected on admission and within 6 months after surgery.According to the QoL assessment at 6 months after surgery,they were divided into a high-quality group(n=136)and a non-high-quality group(n=131).LASSO regression was used to screen the predictors,and multivariate Logistic regression was established to construct the predictive model of QoL of TKA patients at 6 months after surgery.Receiver operating character-istic curve(ROC curve),calibration curve and decision curve were drawn to evaluate its predictive value.Result:A total of 131(49.06%)patients had lower QoL than normal 6 months after TKA.LASSO regression selected age,surgical side,education level,duration of knee osteoarthritis(KOA),perioperative recovery,and visual analog scale(VAS)during preoperative rest as predictors.Multivariate logistic regression analysis showed that age(OR,1.08;95%CI,1.01-1.15),duration of KOA(OR,1.13;95%CI,1.05-1.22),VAS during preoperative rest(OR,1.94;95%CI,1.20-3.15),and perioperative rehabilitation(OR,0.42;95%CI,0.18-0.97)were independent risk factors for lower than normal QoL in TKA patients at 6 months after surgery(P<0.05).Statistically significant indicators in multivariate logistic regression analysis were includ-ed in the nomogram model,which underwent internal validation.The area under the ROC curve was 0.829(95%CI,0.779-0.879),indicating good predictive ability of the model.The calibration curve showed good consistency between the predicted probability and the actual probability.The decision curve analysis showed that this model is clinically applicable.Conclusion:Age,duration of KOA,VAS during preoperative rest,and perioperative rehabilitation are indepen-dent predictors of lower-than-normal QoL in TKA patients at 6 months after surgery,and the nomogram mod-el based on the above indicators had good predictive performance.
