髋关节置换手术后认知功能障碍预测模型的构建  

Construction of cognitive dysfunction after hip replacement surgery

作　　者：张目 何红慧 ZHANG Mu;HE Hong-hui(Xinzhou District Hospital of Traditional Chinese Medicine,Wuhan,Hubei 430400,China)

机构地区：[1]武汉市新洲区中医医院,湖北武汉430400

出　　处：《中国国境卫生检疫杂志》2021年第S01期133-134,共2页Chinese Journal of Frontier Health and Quarantine

摘　　要：目的探讨通过构建预测模型在早期评估髋关节置换术后发生认知功能障碍(POCD)的应用价值。方法纳入2018—2020年间我院行髋关节置换术患者150例,根据术后是否发生POCD分为POCD组(36例)和非POCD组(114例)。采用Logistics回归分析影响髋关节置换术患者发生POCD的危险因素,通过逻辑回归方式构建预测模型,并对模型进行受试者工作特征(ROC)曲线检验效能。结果POCD组术前SDS评分≥53分、年龄≥80岁、糖尿病比例、颈动脉狭窄比例、衰弱GFI评分≥5分比例高于非POCD组(P<0.05)。术前SDS评分≥53分、年龄≥80岁、糖尿病、颈动脉狭窄、GFI评分≥5分是导致髋关节置换术后发生POCD的独立危险因素(OR分别为5.413、12.835、33.978、50.133、81.116,P<0.05)。ROC曲线分析显示预测模型曲线下面积为0.908(95%CI=0.850~0.949),截点值为74分,敏感性为97.2%,特异性为72.8%。结论抑郁、年龄、糖尿病、颈动脉狭窄以及患者衰弱状态均是影响髋关节置换术后发生POCD的因素,建立预测模型能做到早期预警,指导制定干预手段。Objective To explore the application value of constructing a predictive model in the early assessment of postoperative cognitive dysfunction(POCD)after hip replacement.Methods 150 patients who underwent hip arthroplasty in our hospital from 2018 to 2020 were included.According to whether the patients had POCD after operation,they were divided into POCD group(n=36)and non-POCD group(n=114).Logistics regression analysis was used to analyze the risk factors of POCD in patients undergoing hip replacement.Predictive models were constructed by logistic regression,and the receiver operating characteristic(ROC)curve was used to test the effectiveness of the model.Results The proportion of diabetes,the proportion of carotid artery stenosis,and the proportion of frail GFI score≥5 were higher than those in the non-POCD group(P<0.05).Preoperative SDS score≥53 points(OR=5.413),age≥80 years(OR=12.835),diabetes(OR=33.978),carotid artery stenosis(OR=50.133),GFI score≥5 points(OR=81.116)were risk factors for POCD after hip replacement(P<0.05).ROC curve analysis showed that the area under the curve of the prediction model was 0.908(95%CI=0.850-0.949),The cutoff value was 74 points,the sensitivity was 97.2%,and the specificity was72.8%.Conclusion Depression,age,diabetes,carotid artery stenosis,and patient frailty are all factors that affect the occurrence of POCD after hip replacement.The establishment of a predictive model can achieve early warning and guide clinical interventions.

关 键 词：髋关节置换术 认知功能障碍 预测模型 

分 类 号：R183[医药卫生—流行病学]