关键词:

髋关节翻修术, 输血, 危险因素, 列线图

Abstract:

Objective To investigate the risk factors of perioperative blood transfusion in patients undergoing hip revision，and to provide guidance for early screening the patients at high risks of postoperative blood transfusion. Methods A total of 162 patients who had undergone hip revision surgery during the period from August 2012 to March 2021 were included in this study. They were divided into a transfusion group（88 patients）and a non⁃trans⁃ fusion group（74 patients）according to whether they received blood transfusion，with a transfusion rate of 54.32%. The data on age，gender，BMI，hypertension，diabetes，osteoporosis，preoperative red blood cells，preoperative hemoglobin，preoperative platelets，preoperative PT，preoperative APTT，preoperative INR，preoperative TT， preoperative blood calcium，preoperative albumin，ASA score and postoperative allogeneic blood transfusion were collected from both groups. The SPSS software was used to analyze the risk factors of postoperative blood transfusion in patients with hip revision. The R software（4.1.1）was used to build a nomogram prediction model，and the ROC curve and calibration curve were drawn to evaluate the differentiation and standard degree of the model. Results Multivariate binary logistic regression analysis showed that hypertension（OR = 2.249，P = 0.037），osteoporosis （OR = 3.927，P = 0.001），preoperative hemoglobin（OR = 0.255，P = 0.026）and preoperative blood calcium levels （OR = 0.338，P = 0.038）were risk factors for postoperative blood transfusion in hip revision patients. R software was used to construct a nomogram prediction model and draw a ROC curve and a calibration curve. The area under the curve（AUC）was 0.751，and the slope of the calibration curve was close to 1，indicating that the prediction model had good differentiation and accuracy in predicting the risks of postoperative blood transfusion. Conclusions The nomogram has better differentiation and accuracy in predicting the risks of postoperative blood transfusion in hip revision patients，which is established based on five independent risk factors including hypertension，osteoporosis， preoperative hemoglobin and preoperative blood calcium.

Key words: hip revision,  , blood transfusion,  , risk factors,  , nomogram