医学临床研究
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医学临床研究  2023, Vol. 40 Issue (12): 1895-1898    DOI: 10.3969/j.issn.1671-7171.2023.12.021
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改良DORSSSP评分系统评分联合NLR对老年髋部骨折患者术后并发症的预测价值
黄军锋, 杨乐, 杨森
宝鸡市中医医院手足显微骨科,陕西 宝鸡 721000
The Predictive Value of Improved DORSSSP Scoring System Combined with NLR Level for Postoperative Complications in Elderly Patients with Hip Fractures
HUANG Junfeng, YANG Le, YANG Sen
Department of Hand and Foot Microorthopedics, Baoji City Hospital of Traditional Chinese Medicine, Baoji Shaanxi 721000
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摘要 【目的】探讨改良大坪骨科老年患者手术风险评分系统(DORSSSP)评分联合中性粒细胞与淋巴细胞比值(NLR)对老年髋部骨折患者术后并发症发生的预测价值。【方法】选取2019年1月至2022年12月在本院行手术治疗的160例老年髋部骨折患者,术后随访3个月,根据术后有无并发症的发生分为并发症组和无并发症组。收集患者性别、年龄、体重指数(BMI)、改良DORSSSP评分及NLR等临床资料,采用单因素及多因素Logistic回归分析老年髋部骨折患者术后并发症发生的影响因素;采用受试者工作特征(ROC)曲线评估改良DORSSSP评分联合NLR对老年髋部骨折患者术后并发症发生的预测价值。【结果】老年髋部骨折患者术后并发症发生率为31.88%(51/160)。单因素分析结果显示:两组性别、BMI、骨折部位、手术方法、美国麻醉师协会(ASA)分级、合并高血压、手术时间比较,差异无统计学意义(P>0.05);并发症组年龄、合并糖尿病占比、C反应蛋白(CRP)水平、白细胞计数(WBC)、改良DORSSSP评分和NLR均明显高于无并发症组(P<0.05)。多因素Logistic回归分析结果显示:高改良DORSSSP评分(OR=1.755)、高NLR(OR=2.147)、年龄大(OR=2.658)、高CRP(OR=2.324)水平是影响老年髋部骨折患者术后并发症发生的独立危险因素(P<0.05)。ROC曲线分析显示:改良DORSSSP评分、NLR及两者联合预测老年髋部骨折患者术后并发症发生的曲线下面积(AUC)分别为0.686、0.714、0.898。【结论】高改良DORSSSP评分与高NLR是影响老年髋部骨折患者术后并发症发生的危险因素,且二者联合对老年髋部骨折患者术后并发症发生具有较高的预测价值。
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黄军锋
杨乐
杨森
关键词 髋骨折/外科学淋巴细胞中性白细胞比值比手术后并发症老年人    
Abstract:【Objective】To explore the predictive value of the modified Daping Orthopaedic Surgery Risk Scoring System (DORSSSP) score combined with neutrophil to lymphocyte ratio (NLR) level for postoperative complications in elderly patients with hip fractures. 【Methods】A total of 160 elderly patients with hip fractures admitted to our hospital from January 2019 to December 2022 were enrolled in this study. After admission, all patients underwent surgical treatment, and a 3-month follow-up was conducted to record the occurrence of postoperative complications. According to the occurrence of postoperative complications, patients were divided into the complication group and the non-complication group. Relevant clinical data of patients such as gender, age, body mass index, the modified DORSSSP score and the NLR level were collected. Single factor and multivariate logistic regression were used to analyze the factors influencing the occurrence of postoperative complications in patients. The predictive value of the modified DORSSSP score combined with NLR level detection for postoperative complications in patients was evaluated using the subject performance characteristic (ROC) curve. 【Results】The postoperative complication rate of elderly patients with hip fracture was 31.88% (51/160). The results of univariate analysis showed that there were no statistical differences in gender, body mass index (BMI), fracture location, surgical method, ASA grade, comorbid hypertension, and operative time between the two groups (P>0.05). Age, proportion of comorbid diabetes mellitus, C-reactive protein (CRP) level, and white blood cell count (WBC) level were significantly higher in the complication group than in the non-complication group (P<0.05). The modified DORSSSP scores and NLR level of the patients in the complication group were significantly higher than those in the uncomplicated group (P<0.05). Multivariate logistic regression analysis showed that high modified DORSSSP score (OR=1.755), high NLR level (OR=2.147), advanced age (OR=2.658), and high CRP (OR=2.324) level were independent risk factors for the development of postoperative complications (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the modified DORSSSP score, NLR level and the combined prediction of both DORSSSP score and NLR for postoperative complications in elderly hip fracture patients were 0.686, 0.714 and 0.898, respectively. 【Conclusion】The modified DORSSSP score and NLR level are risk factors for postoperative complications in elderly patients with hip fractures. The combination of both modified DORSSSP scoring and NLR level provides better predictive value for the evaluation of the occurrence of postoperative complications in patients.
Key wordsHip Fractures/SU    Lymphocytes    Neutrophils    Odds Ratio    Postoperative Complications    Aged
收稿日期: 2023-05-18     
中图分类号:  R457.1  
引用本文:   
黄军锋, 杨乐, 杨森. 改良DORSSSP评分系统评分联合NLR对老年髋部骨折患者术后并发症的预测价值[J]. 医学临床研究, 2023, 40(12): 1895-1898.
HUANG Junfeng,YANG Le,YANG Sen. The Predictive Value of Improved DORSSSP Scoring System Combined with NLR Level for Postoperative Complications in Elderly Patients with Hip Fractures. JOURNAL OF CLINICAL RESEARCH, 2023, 40(12): 1895-1898.
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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.12.021     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I12/1895
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