实用医学杂志2023年第39卷第18期TheJournalofPracticalMedicine2023Vol.39No.18骨质疏松椎体压缩性骨折患者术后再骨折的风险列阵图构建与验证田烨袁秋文胡梁深南昌市洪都中医院(南昌330038)【摘要】目的探讨影响骨质疏松椎体压缩性骨折(osteoporoticvertebralcompressionfractures,OVCF)患者术后再骨折的危险因素,建立风险预警模型并进行验证。方法选取2020年1月至2021年6月于南昌市洪都中医院180例行手术治疗的OVCF患者,依据患者是否发生再骨折将其分为再骨折组和未再骨折组,对相关因素进行logistic回归分析,构建列线图风险模型并进行验证。结果180例行手术治疗的OVCF患者中,术后再骨折的发生率为22.78%。因素分析结果显示,年龄≥60岁、骨水泥渗漏、术后低骨密度、高骨水泥注射率和术后后凸Coob角度是OVCF术后再骨折的独立危险因素(P<0.05),术后长期抗骨质疏松治疗、高BMI是独立保护因素(P<0.05)。Hosmer-Lemeshow拟合优度检验结果显示,ROC曲线下面积为0.979(95%CI:0.957~1.000,P<0.001),灵敏度为92.70%,特异度为96.40%,最大约登指数为0.891,模型校正曲线总体趋势接近理想曲线。决策曲线分析结果显示为表现为正的净效益。结论OVCF患者术后再骨折的发生受多重因素共同影响,根据危险因素建立的风险预警模型具有较好的预测效能。【关键词】骨质疏松椎体压缩性骨折;手术;再骨折;风险预警模型【中图分类号】R687.3Constructionandvalidationofriskwarningmodelofpostoperativere⁃fractureinpatientswithosteoporo⁃sisvertebralcompressibilityfractureTIANYe,YUANQiuwen,HULiangshen.NanchangHongduTraditionalChineseMedicineHospital,Nanchang330038,China【Abstract】ObjectiveToexploretheriskfactorsofpostoperativere-fractureinpatientswithosteoporoticvertebralcompressibilityfracture(OVCF),andtoestablishariskearlywarningmodelandverifyit.MethodsOnehundredandeightyOVCFpatientswhounderwentsurgicaltreatmentinnanchanghongdutraditionalchinesemedicinehospitalfromJanuary2020toJune2021wereselectedanddividedintoare-fracturegroupandanonre-fracturegroup.Logisticregressionanalysiswasperformed,andalinechartriskmodelwasconstructedandvalidated.ResultsAmong180OVCFpatientswhounderwentsurgicaltreatment,theincidenceofpostoperativefractureswas22.78%.Factoranalysisshowedtha...