髋部骨折术后非计划入住重症监护病房的列线图预测模型构建与分析

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Abstract Objective To analyze the risk factors of unplanned admission to intensive care unit (ICU) after hip fracture surgery and construct a clinical nomogram to identify patients early in order to improve the clinical treatment and nursing effect and reasonably allocate medical resources.Methods A total of 1426 elderly patients with hip fracture in the general inpatient ward from January 2010 to December 2019 were retrospectively analyzed，and 1294 study subjects were included.There were 425 males and 869 females，aged (65~88) years，with an average age of (77.3±10.4) years.The variables of demographic characteristics，coexisting underlying diseases at admission，and laboratory test results were collected，and a nomogram prediction model was established by a combination of variable screening and regression analysis.The data of 206 elderly patients with hip fracture in the Department of Orthopaedics of our hospital from January 2020 to December 2020 (validation group) were retrospectively analyzed，including 69 males and 137 females，aged (65~90) years，with an average age of (77.9±11.3) years.The predictive power of the nomogram was tested.Results (1)Age，diabetes mellitus，coronary heart disease，chronic obstructive pulmonary disease，chronic heart failure，chronic kidney disease，albumin，hemoglobin，creatinine，glomerular filtration rate，and urea nitrogen were associated with unscheduled intensive care unit admission by univariate analysis in the model establishment.(2)Seven of the variables remained significant predictors in multivariate logistic regression analysis，which were age，coronary heart disease，chronic heart failure，chronic obstructive pulmonary disease，Parkinson's disease，serum creatinine，and albumin concentration.(3)The odds ratio calculated based on nomogram was 0.27%，and patients with unplanned intensive care unit admission were significantly higher in the model validation group than in the model establishment group (P＜0.01).The area under the curve of AUC was 0.905 (95% CI，0.91~0.99)，with good discrimination.The Hosmer-Lemesshow test showed that the nomogram prediction model had good correction ability (χ²=3.648，P＝0.529)，with good consistency.Conclusion Age，coronary heart disease，chronic heart failure，chronic obstructive pulmonary disease，Parkinson's disease，serum creatinine，and albumin concentration can be used as predictors of unplanned admission to the intensive care unit after hip fracture surgery，and this nomogram model has good discrimination and correction ability and good consistency.

Key words： hip fracture unplanned intensive care unit nomogram

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	Articles by authors
	Shao Fei
	Li Yan
	Chen Jing
	Wang Xudong

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Shao Fei,Li Yan,Chen Jing, et al. Construction and Analysis of Nomogram Prediction Model for Unplanned Admission to Intensive Care Unit After Hip Fracture Surgery[J]. sygkzz, 2022, 27(2): 114-119.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V27/I2/114

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