The Journal of Practical Medicine >
Establishment of Nomogram prediction model for latent blood loss in patients with lumbar disc herniation after operation
Received date: 2023-06-12
Online published: 2023-10-10
Objective To analyze the risk factors of recessive blood loss in patients with lumbar disc herniation after surgery and establish a nomogram prediction model. Methods Two hundred patients with lumbar disc herniation who came to our hospital from February 2019 to August 2022 were selected as the research objects. According to the recessive blood loss after surgery, the patients were divided into positive group (n = 85) and negative group (n = 115). ROC experiment was used to analyze the predictive value of continuous variables. Logistic regression experiment was used to analyze the risk factors of recessive blood loss in patients with lumbar disc herniation after operation. Internal data were used to verify the clinical efficacy of Nomogram model. Results There was no significant difference in gender, BMI and other general data between the two groups (P > 0.05). Compared with the negative group, the patients in the positive group were older, and they had more perioperative blood transfusions, larger number of surgical segments, higher TC and TG levels, and lower postoperative hemoglobin levels (P < 0.05). The AUCs of age, number of operative segments, TC, TG and postoperative hemoglobin were 0.611, 0.607, 0.602, 0.673, 0.791, respectively, with the optimal cutoff values 39 years, 2 segments, 4.96 mmol/L, 6.79 mmol/L, 107 g/L, respectively. Age (> 39 years), perioperative blood transfusion, number of operative segments (> 2 segments), TC (> 4.96 mmol/L), TG (> 6.79 mmol/L), and hemoglobin difference (> 44 g/L) were all risk factors for recessive blood loss in the patients (P < 0.05). Nomogram model predicted the risk of occult blood loss in the patients after surgery by a C-index of 0.775 (95% CI: 0.669 ~ 0.848), with a risk threshold of recessive blood loss > 0.07. Nomogram model predictively yielded clinical net benefits as well. Conclusion Age (> 39 years), perioperative blood transfusion, number of operative segments (> 2 segments), TC (> 4.96 mmol/L), TG (> 6.79 mmol/L), and hemoglobin difference (> 44 g/L) are all risk factors that affect the occurrence of recessive blood loss in patients with lumbar disc herniation after surgery. Nomogram model based on the above variables can better predict the occurrence of recessive blood loss in those patients.
Xiuquan QI , Wei WANG , Xiaokang QIU , Ye. XU . Establishment of Nomogram prediction model for latent blood loss in patients with lumbar disc herniation after operation[J]. The Journal of Practical Medicine, 2023 , 39(18) : 2300 -2305 . DOI: 10.3969/j.issn.1006-5725.2023.18.003
| 1 | OLBY N J, MOORE S A, BRISSON B, et al. ACVIM consensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion[J]. J Vet Intern Med,2022,36(5):1570-1596. |
| 2 | 孙剑峰,邓建伟,张迪,等. 通络活血酊联合杵针治疗血瘀气滞型腰椎间盘突出症的疗效[J]. 实用医学杂志,2022,38(9):1147-1151. |
| 3 | 中华医学会疼痛学分会脊柱源性疼痛学组. 腰椎间盘突出症诊疗中国疼痛专家共识[J]. 中国疼痛医学杂志,2020,26(1):2-6. |
| 4 | SHENG Y, LI J, CHEN L, et al. Delta large-channel technique versus microscopy-assisted laminar fenestration decompression for lumbar spinal stenosis: a one-year prospective cohort study[J]. BMC Musculoskelet Disord, 2023,24(1):43. |
| 5 | WANG F, GUO D, SUN T, et al.A comparative study on short-term therapeutic effects of percutaneous transforaminal endoscopic discectomy and microendoscopic discectomy on lumbar disc herniation[J]. Pak J Med Sci, 2019, 35(2):426-431. |
| 6 | HU M, ZHANG Y, ZHAO W J, et al.Perioperative Hidden Blood Loss in Lumbar Disk Herniation Patients With Percutaneous Endoscopic Transforaminal Discectomy and Influencing Factors[J]. Clin Spine Surg, 2022,35(5):E438-E443. |
| 7 | OUYANG X, DING Y, YU L, et al. Comparison of the clinical effect of DHS and PFNA on senile osteoporotic fracture and their significance of changes in BALP expression level[J]. J Musculoskelet Neuronal Interact,2020,20(4):556-562. |
| 8 | 朱东平,杨伟毅,潘建科,等. 初次单侧单髁置换术后隐性失血危险因素的分析[J]. 实用医学杂志,2018,34(6):946-948. |
| 9 | 张鑫微,张志军,贾若,等. 真实世界腰椎融合术后胃肠功能障碍的影响因素分析及Nomogram预测模型建立[J]. 北京医学,2022,44(4):292-297. |
| 10 | 殷振华,董辉辉,陈轲,等. 隐性失血对全膝关节置换术后膝关节功能的影响[J]. 实用骨科杂志,2016,22(2):118-121. |
| 11 | WANG L, HE T, LIU J, et al. Revealing the Immune Infiltration Landscape and Identifying Diagnostic Biomarkers for Lumbar Disc Herniation[J]. Front Immunol,2021,12:666355.. |
| 12 | YILDIRIM P, GULTEKIN A. The Effect of a Stretch and Strength-Based Yoga Exercise Program on Patients with Neuropathic Pain due to Lumbar Disc Herniation[J]. Spine (Phila Pa 1976), 2022,47(10):711-719. |
| 13 | 穆莹,姚鹏. 不同数量穿刺通道低温等离子髓核成形术治疗腰椎间盘突出症的疗效[J]. 实用医学杂志,2021,37(22):2882-2886. |
| 14 | 中国康复医学会脊柱脊髓专业委员会基础研究与转化学组.腰椎间盘突出症诊治与康复管理指南[J]. 中华外科杂志,2022,60(5):401-408. |
| 15 | GUO Y N, CUI S J, ZHOU Y H, et al. An Overview of Anterior Repositioning Splint Therapy for Disc Displacement-related Temporomandibular Disorders[J]. Curr Med Sci,2021,41(3):626-634. |
| 16 | KERCKHOVE M F V, FIERE V, VIEIRA T D, et al. Postoperative pain due to an occult spinal infection: A case report[J].World J Clin Cases,2021,9(15):3637-3643. |
| 17 | 李承锦,江利敏,宋娜娜. 胸腰椎爆裂性骨折内固定术后发生隐性失血的影响因素分析[J]. 中国实用医刊,2021,48(21):9-12. |
| 18 | SLICHTER S J, GERNSHEIMER T, LEBLANC R, et al. Fecal blood loss: A quantitative method of evaluating hemostasis in patients with thrombocytopenia[J]. Transfusion,2021,61(2):393-403. |
| 19 | JáVOR P, RáROSI F, HORVáTH T, et al. Detection of exhaled methane levels for monitoring trauma-related haemorrhage following blunt trauma: study protocol for a prospective observational study[J]. BMJ Open,2022,12(7):e057872. |
| 20 | DENG Z F, ZHANG Z J, SHENG P Y, et al. Effect of 3 different anticoagulants on hidden blood loss during total hip arthroplasty after tranexamic acid[J]. Medicine (Baltimore),2020,99(36):e22028. |
| 21 | HALVACHIZADEH S, KALBAS Y, TEUBEN M P J, et al. Effects of Occult Hypoperfusion on Local Circulation and Inflammation-An Analysis in a Standardized Polytrauma Model[J]. Front Immunol,2022,13:894270. |
| 22 | 陈美英,王芹燕,盖茂杨,等. 胸腰段脊椎爆裂性骨折减压内固定术后隐性失血量的影响因素分析[J]. 颈腰痛杂志,2021,42(6):878-880. |
| 23 | MEESTER R G S, VAN DE SCHOOTBRUGGE-VANDERMEER H J, BREEKVELDT E C H, et al.Faecal occult blood loss accurately predicts future detection of colorectal cancer.A prognostic model[J]. Gut,2023,72(1):101-108. |
| 24 | YEFET E, YOSSEF A, SULEIMAN A, et al. Hemoglobin drop following postpartum hemorrhage[J]. Sci Rep,2020,10(1):21546. |
| 25 | 余佩沅,莫凌,杨志东,等. 椎板开窗与椎间孔镜治疗腰椎间盘突出症术后隐性失血比较分析[J]. 中国骨与关节杂志,2021,10(1):52-55. |
/
| 〈 |
|
〉 |