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Establishment and Validation of a Nomogram for the Risk of New Vertebral Compression Fractures After Percutaneous Vertebroplasty in Patients With Osteoporotic Vertebral Compression Fractures: A Retrospective Study
Geriatric Orthopaedic Surgery & Rehabilitation ( IF 1.6 ) Pub Date : 2022-05-03 , DOI: 10.1177/21514593221098620
FuCheng Bian 1, 2 , GuangYu Bian 3 , YongSheng An 4 , DaYong Wang 2 , JinHui Fang 1
Affiliation  

Purpose

New vertebral compression fractures(NVCFs) after minimally invasive surgery in patients with osteoporotic vertebral compression fracture (OVCF) is a challenging issue worldwide. Predicting the occurrence of NVCFs is key to addressing such questions. Therefore, we aimed to investigate the risk factors for patients who developed NVCFs after undergoing surgical treatment and establish a nomogram model to reduce the occurrence of NVCFs.

Methods

This study is a retrospective analysis that collected the general characteristics and surgical features of patients who underwent surgical treatment at 2 central institutions between January 2017 and December 2020. Patients were divided into training and testing sets based on the presence or absence of NVCFs. Independent risk factors for NVCFs were obtained in the training set of patients, and then a nomogram model was constructed. Internal and external validation of the nomogram model was performed using the consistency index (C index), receiver operating characteristic curve(ROC), calibration curves, and decision curve analysis (DCA).

Results

A total of 562 patients were included in this study. Patients from the first center were used for nomogram construction and internal validation, and patients from the second center were used as an external validation population. Multivariate regression analysis showed that age, Hounsfield unit (Hu) value, cement leakage, and thoracolumbar (TL) junction fracture were independent risk factors for NVCFs after minimally invasive surgery. The C index was .85, and the validation of internal and external validation shows that the predicted values of the established model is in good agreement with the actual values.

Conclusions

In this study, 4 independent risk factors were obtained by regression analysis, and a nomogram model was constructed to guide clinical work. The application of this model can help surgeons to make more accurate judgments to prevent the occurrence of NVCFs.



中文翻译:

骨质疏松性椎体压缩性骨折患者经皮椎体成形术后新椎体压缩性骨折风险列线图的建立和验证:一项回顾性研究

目的

骨质疏松性椎体压缩性骨折(OVCF)患者微创手术后新发椎体压缩性骨折(NVCFs)是世界范围内的一个具有挑战性的问题。预测 NVCF 的发生是解决此类问题的关键。因此,我们旨在调查接受手术治疗后发生 NVCFs 的患者的危险因素,并建立列线图模型以减少 NVCFs 的发生。

方法

本研究是一项回顾性分析,收集了 2017 年 1 月至 2020 年 12 月期间在 2 个中心机构接受手术治疗的患者的一般特征和手术特征。根据 NVCF 的存在与否将患者分为训练组和测试组。在患者的训练集中获得 NVCFs 的独立危险因素,然后构建列线图模型。使用一致性指数(C 指数)、受试者工作特征曲线(ROC)、校准曲线和决策曲线分析(DCA)对列线图模型进行内部和外部验证。

结果

本研究共纳入 562 名患者。来自第一中心的患者用于列线图构建和内部验证,来自第二中心的患者用作外部验证人群。多元回归分析显示,年龄、Hounsfield unit(Hu)值、骨水泥渗漏、胸腰椎(TL)交界处骨折是微创术后NVCFs的独立危险因素。C指数为0.85,内外验证验证表明,所建立模型的预测值与实际值吻合较好。

结论

本研究通过回归分析得到4个独立危险因素,构建列线图模型指导临床工作。该模型的应用可以帮助外科医生做出更准确的判断,防止NVCFs的发生。

更新日期:2022-05-07
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