老年髋部骨折患者术后髋关节康复的影响因素回归方程构建研究

Construction of a regression equation for factors influencing postoperative hip joint rehabilitation in elderly patients with hip fracture

中文关键词: 老年  髋部骨折  术后  髋关节康复  回归方程  受试者工作特征曲线

英文关键词: elderly  hip fracture  postoperation  hip joint rehabilitation  regression equation  receiver operating charac-teristic curve

中文摘要:

      目的 构建老年髋部骨折(HF)患者术后髋关节康复的影响因素回归方程,为筛选高危患者、采取预防干预措施奠定基础.方法 回顾性选取2022年1月—2024年3月江南大学附属医院收治的215例老年HF患者的临床资料,根据术后半年康复情况(康复情况优良定义为髋关节Harris评分≥ 80分)分为康复优良组(n=157)和康复不良组(n=58).分析老年HF患者术后髋关节康复情况;采用单因素、多因素Logistic回归分析老年HF并发髋关节康复不良的危险因素,建立影响因素回归方程,并绘制受试者工作特征(ROC)曲线,分析其预测价值.结果 215例老年HF患者术后半年康复不良58例,发生率为26.98％.多因素Logistic分析结果显示,年龄升高、合并症≥2种、经济收入降低为影响老年HF术后髋关节康复不良的危险因素(P＜0.05).将上述因素纳入影响因素回归方程:logit(P)=-2.310+年龄×0.637+合并症× 0.753+经济收入×0.659.ROC曲线结果显示,当最佳截断值为logit(P)=0.75,曲线下面积(AUC)为0.880,诊断敏感度为81.03％、特异度为83.44％.结论 老年HF患者术后髋关节康复情况影响因素较多,据此构建回归方程可能为筛选高危患者提供依据.

英文摘要:

      Objective To construct a regression equation for factors influencing postoperative hip joint rehabilitation in elderly patients with hip fracture(HF),and provide a basis for screening high-risk patients and implementing preventive inter-vention measures.Methods The clinical data from 215 elderly HF patients treated in Affiliated Hospital of Jiangnan University between January 2022 and March 2024 were retrospectively collected.According to the rehabilitation condition half a year after the operation(an excellent rehabilitation condition was defined as a Harris score of the hip joint ≥80 points),they were divid-ed into excellent rehabilitation group(n=157)and poor rehabilitation group(n=58).Their postoperative hip rehabilitation condition was analyzed.Univariate and multivariate Logistic regression analyses were used to identify risk factors for poor hip joint rehabilitation in elderly HF patients.A regression equation for influencing factors was established,and the receiver operat-ing characteristic(ROC)curve was used to analyze its predictive value.Results Among 215 elderly HF patients,58 cases had poor rehabilitation half a year after the operation,with an incidence of 26.98％.Multivariate Logistic regression analysis showed that advanced age,≥2 kinds of comorbidities,and decreased economic income were independent risk factors for poor postopera-tive hip joint rehabilitation(P＜0.05).The above factors were included in the regression equation for influencing factors:logit(P)=-2.310+age × 0.637+comorbidities × 0.753+economic income × 0.659.The results of ROC curve analysis showed that when the optimal cut-off value was logit(P)=0.75,the area under the curve(AUC)was 0.880,with a diagnostic sensitivity of 81.03％and the specificity of 83.44％.Conclusion There are many factors influencing postoperative rehabilita-tion of hip joint in elderly HF patients.The constructed regression equation may provide a basis for screening high-risk patients.