膝关节镜术后慢性期疼痛预测模型的构建与验证

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Abstract Objective To explore the risk factors for moderate to severe pain in the chronic stage after knee arthroscopy and to construct and validate a prediction model.Methods Clinical data were collected from 236 patients who underwent knee arthroscopic surgery at Tangdu Hospital between September 2019 and February 2021.Patients with NRS≥4 points were included in the pain group，and those with NRS<4 points were included in the pain free group according to the numerical rating scale (NRS) for pain at 3 months after surgery.29 patients，including 13 males and 16 females，with a mean age of (62.03±9.52) years were in the postoperative chronic stage pain group and 207 patients，including 114 males and 93 females，with a mean age of (40.00±12.46) years.Multivariate logistic regression analysis was used to compare the independent risk factors for chronic postoperative pain (CPSP) between the two groups.Based on the clinical indexes obtained from screening，a nomogram prediction model was constructed in R language，and bootstrap bootstrap sampling was used for internal validation.The predictive ability of the model was evaluated by receiver operating characteristic (ROC) curve and calibration curve.Results The results of univariate analysis showed that the risk factors for pain in the chronic stage after surgery were age，body mass index (BMI)，Outerbridge grade of articular cartilage damage，NRS≥4 points at 72 h after surgery，and having diabetes mellitus or not.In multivariate analysis，advanced age，BMI≥24 kg／m²，Outerbridge grades Ⅲ to Ⅳ，and NRS≥4 points at 72 h postoperatively were independent risk factors for pain in the chronic stage after knee arthroscopy.A nomogram prediction model was constructed based on the results of multivariate analysis，and internal validation showed that the C-index was 0.968，the area under the ROC curve was 0.969，and the predictive results of the calibration curve and the actual observation were in good agreement.Conclusion Advanced age，BMI≥24 kg／m²，Outerbridge grades Ⅲ to Ⅳ，and NRS≥4 points at 72 h after knee arthroscopy are the risk factors for pain in the chronic stage，and the nomogram model constructed based on the above factors has high accuracy and clinical usefulness.

Key words： arthroscopy chronic post surgical pain risk factors nomogram

Corresponding Authors: Ding Yong

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	Articles by authors
	Feng Chongyang
	Ji Zhenwei
	Wu Peng
	Wang Zhixue
	Zhang Zhixiang
	Fang Huaiming
	Ding Yong

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Feng Chongyang,Ji Zhenwei,Wu Peng, et al. Construction and Validation of a Pain Prediction Model for the Chronic Stage After Knee Arthroscopy[J]. sygkzz, 2022, 28(11): 966-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I11/966

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