摘要
目的根据已知的围手术期神经认知障碍的危险因素,以及老年髋部骨折患者的特点,应用临床信息和生物学标志物初步建立围手术期神经认知障碍的风险预测模型。方法前瞻性选取2019年1~9月首都医科大学附属北京友谊医院收治的129例髋部骨折患者,其中发生围手术期神经认知障碍44例,未发生85例。分别采用单因素及多因素Logistic分析对于其危险因素进行筛选并建立模型,应用受试者工作特征曲线(ROC曲线)进行模型效能验证。结果年龄、术前合并神经系统疾病、术后白蛋白值及术后血红蛋白被纳入本模型中,模型为:P=1/1+e(-z),(z=0.083×年龄+1.522×术前是否合并神经系统疾病-0.196×术后白蛋白值+0.022×术后血红蛋白值-4.708)。曲线下面积(AUC)为0.820(95%CI:0.747~0.894)。结论本模型对于老年髋部骨折围手术期神经认知障碍的早期预测有一定参考价值。
Objective To preliminarily establish the risk prediction model of perioperative neurocognitive disorders(PND)by using clinical information and biological markers,based on the known risk factors of perioperative neurocognitive disorders and the characteristics of the elderly patients with hip fracture.Methods 129 patients with hip fracture admitted in Beijing Friendship Hospital,Capital Medical University from January to September 2019 were prospectively selected.Among them,44 patients had perioperative neurocognitive disorders,85 patients did not.Univariate and multivariate logistic analysis were used to screen the risk factors and establish the model,and receiver operating characteristic(ROC)curve was used to verify the effectiveness of the model.Results Age,preoperative complications of neurological diseases,postoperative albumin value and postoperative hemoglobin value were included in the model.The model was:P=1/1+e(-z),z=0.083×age+1.522×preoperative complications of neurological diseases-0.196×postoperative albumin value+0.022×postoperative hemoglobin value-4.708.Area under the curve(AUC)was 0.820(95%CI:0.747~0.894).Conclusion This model has a certain reference value for the early prediction of perioperative neurocognitive disorders of hip fracture in the elderly.
作者
李超
何农
曾娜
李修良
王芳
马立峰
白晓冬
张亚强
薛富善
LI Chao;HE Nong;ZENG Na(Department of Anesthesiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;National Clinical Research Center for Digestive Diseases,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2020年第5期537-541,共5页
Journal of Clinical and Experimental Medicine
基金
北京市医院管理局"培育计划"(编号:PX20200105).
关键词
髋部骨折
围术期神经认知障碍
预测模型
Hip fracture
Perioperative neurocognitive disorders
Prediction model
