Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3720-3728
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3720
Nomogram to predict postoperative complications in elderly with total hip replacement
Xiu-Juan Tan, Xiao-Xia Gu, Feng-Min Ge, Zhi-Yi Li, Liang-Qing Zhang
Xiu-Juan Tan, Department of Anesthesiology, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
Xiao-Xia Gu, Feng-Min Ge, Zhi-Yi Li, Liang-Qing Zhang, Department of Anesthesiology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
Author contributions: Tan XJ is first Author, participated in protocol writing, collecting data, statistical analysis, interpretation of results and manuscript writing; Ge FM helped collection of cases; Li ZY participated in protocol writing, essay writing; Gu XX helped interpretation of results and manuscript writing; Zhang LQ did the statistical analysis and reviewed the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Guangdong Medical University with the reference number PJ2020-022.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang-Qing Zhang, MD, PhD, Professor, Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue Xiashan District, Zhanjiang 524001, Guangdong Province, China. lngkkt@126.com
Received: October 28, 2021
Peer-review started: October 28, 2021
First decision: February 14, 2022
Revised: February 22, 2022
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: April 26, 2022
Processing time: 174 Days and 19.1 Hours
Abstract
BACKGROUND

By analyzing the risk factors of postoperative complications in elderly patients with hip replacement, We aimed to develop a nomogram model based on preoperative and intraoperative variables and verified the sensitivity and specificity for risk stratification of postoperative complications in elderly with total hip replacement patients.

AIM

To develop a nomogram model for risk stratification of postoperative complications in elderly with total hip replacement patients.

METHODS

A total of 414 elderly patients who underwent surgical treatment for total hip replacement hospitalized at the Affiliated Hospital of Guangdong Medical University from March 1, 2017 to August 31, 2019 were included into this study. Univariate and multivariate logistic regression were conducted to identify independent risk factors of postoperative complication in the 414 patients. A nomogram was developed by R software and validated to predict the risk of postoperative complications.

RESULTS

Multivariate logistic regression analysis revealed that age (OR = 1.05, 95%CI: 1.00-1.09), renal failure (OR = 0.90, 95%CI: 0.83-0.97), Type 2 diabetes (OR = 1.05, 95%CI: 1.00-1.09), albumin (ALB) (OR = 0.91, 95%CI: 0.83-0.99) were independent risk factors of postoperative complication in elderly patients with hip replacement (P < 0.05). For validation of the nomogram, receive operating characteristic curve revealed that the model predicting postoperative complication in elderly patients with hip replacement was the area under the curve of 0.8254 (95%CI: 0.78-0.87), the slope of the calibration plot was close to 1 and the model passed Hosmer-Lemeshow goodness of fit test (χ2 = 10.16, P = 0.4264), calibration in R Emax = 0.176, Eavg = 0.027, which all demonstrated that the model was of good accuracy.

CONCLUSION

The nomogram predicting postoperative complications in patients with total hip replacement constructed based on age, type 2 diabetes, renal failure and ALB is of good discrimination and accuracy, which was of clinical significance.

Keywords: Elderly; Total hip replacement; Postoperative complication; Nomogram

Core Tip: Predictive models refer to the use of multivariate methods in the design and analysis of prognostic studies to identify important predictors of outcomes and to provide a combination of outcome probabilities or tools for estimating such probabilities. Predictive models can be used in a variety of medical settings, primarily to predict the course (or risk) of an individual disease, and to guide doctors and patients in deciding together on further treatment. This study aims to establish prediction model of postoperative complications in elderly patients with total hip replacement is use individualized treatment to assist complex decision-making.