髋部骨折患者术后恐动症风险的列线图分析

doi:10.6040/j.issn.1671-7554.0.2023.0792

摘要/Abstract

摘要： 目的了解髋部骨折(HF)术后恐动症的发生现状,探讨其危险因素并构建列线图预测模型。方法采用便利抽样法,选取2022年1月至2023年5月滨州医学院附属医院创伤骨科符合纳排标准的328例患者,调查患者的一般资料、恐动症评分、心理弹性评分、社会支持评分等,通过Logistic回归分析HF术后恐动症的影响因素,建立列线图风险预测模型并验证模型预测效果。结果 HF术后恐动症的概率为39.94%。Logistic回归分析显示,年龄、疼痛、睡眠障碍是HF恐动症的危险因素;心理弹性、社会支持是HF恐动症的保护因素。列线图模型内部验证显示,C-index为0.880,绘制受试者工作特征(ROC)曲线下面积为0.880(95%CI: 0.845~0.915),H-L检验P=0.181,校正曲线趋近于理想曲线,决策曲线临床应用净效益价值较高。结论年龄、疼痛、睡眠障碍、社会支持、心理弹性是HF术后恐动症的独立影响因素,构建的列线图模型预测效能良好,具有一定的临床应用价值。

关键词: 髋部骨折, 恐动症, 危险因素, 列线图, 预测模型

Abstract: Objective To investigate the incidence of kinesiophobia after hip fracture(HF), and explore the risk factors and construct a nomogram prediction model. Methods A total of 328 patients treated during Jan. 2022 and May 2023 who met the inclusion and exclusion criteria were collected with convenience sampling. The general information, kinesiophobia score, psychological resilience and sleep disorder of patients were investigated. The risk factors of kinesiophobia after HF were analyzed with Logistic regression. A nomogram prediction model was established and its prediction effects were verified. Results The probability of kinesiophobia after HF was 39.94%. Logistic regression showed that age, pain and sleep disorder were risk factors, while social support and psychological resilience were protective factors. The internal verification of the nomogram model showed that the C-index was 0.880; the area under the receiver operating characteristic(ROC)curve was 0.880(95%CI: 0.845-0.915). H-L test showed P=0.181, the correction curve was close to the ideal curve, and the net benefit value of decision curve in clinical application was high. Conclusion Age, pain, sleep disorder, social support and psychological resilience are independent influencing factors for kinesiophobia after HF. The nomogram model has good predictive efficiency and certain clinical value.

Key words: Hip fracture, Kinesiophobia, Risk factor, Nomogram, Prediction model

中图分类号:

R641

张明慧,王丽云,王芸,张新月,沙凯辉. 髋部骨折患者术后恐动症风险的列线图分析[J]. 山东大学学报 (医学版), 2023, 61(11): 74-81.

ZHANG Minghui, WANG Liyun, WANG Yun, ZHANG Xinyue, SHA Kaihui. A nomogram analysis of the risk of kinesiophobia in patients with hip fracture after surgery[J]. Journal of Shandong University (Health Sciences), 2023, 61(11): 74-81.

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