老年下肢骨折患者术后发生急性心脑血管意外的影响因素分析

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中图分类号：R683，R54 文献标志码：A DOI：10.11958/20250587

Abstract：ObjectiveToanalyzerisk factors ofacutecardio-cerebrovascularaccidents in elderlypatientswithlower extremity fracture，and to constructarisk prediction diagram model.MethodsAretrospective analysis was conductedon the clinicaldataof51O elderlypatients with lowerextremityfractures，andthepatients were divided intotheoccurrence groupand the non-occurrence group based on the occurrence of acute cardiovascular and cerebrovascular accidents during the postoperative hospitalization.Univariateand multivariate Logisticregresionanalysiswasused toanalyzerisk factors afecting acutecardiovascularand cerebrovascularacidents in elderly patients with lower extremity fracture，and the risk prediction model wasconstructedandverified.ResultsAtotalof 52cases of acute cardio-cerebrovascularaccidents occurred during hospitalization in 51O patients （10.20% ）.Age，ASAgrade II ratio，preoperative concurrent cerebrovascular disease，postoperative pneumonia ratio and postoperative bed time ⩾5 days ratio were higher in the occurrence group than those in the non-occurrence group （ P<0.05 ）.Multivariate Logistic regresson analysis showed that age，ASA grade preoperativeconcurentcardiovascularandcerebrovasculardisease，andpostoperativepneumonia wererisk factors foracute cardio-cerebrovascular accidents in elderly patients with lower limb fracture （ P<0.05 ）.Multivariate Logistic regression analysis wasusedtoscreenrisk factorsaspredictivevariablestobuildariskearlywarninghistogrammodelforacutecardiocerebrovascularaccidents.Thetotalscorerangedfrom103to168points，corresponding toariskrangeofO.1toO.9ponts. Receiveroperating characteristic curve （ROC）curve results showed that the area under the curve （AUC）of this model for predictingacutecardiovascularandcerebrovascularacidentswas0.980 （95%CI：0.964-1.0o0），and discretechoice approach（DCA）showed that when therisk thresholdwas O.2-0.6，the prediction modelof thiscolumn graph hada good clinicaladvantage.ConclusionTherisk diagram modelconstructed basedonrisk factors hasgood predictive value for the occurrence of acute cardio-cerebrovascular accidents after lower extremity fracture in elderly patients.

KeyWords：cardiovascular diseases; cerebrovascular disorders; fracture; nomogram; aged

骨折是一个全球性的公共卫生问题，也是造成患者医疗经济负担的重要原因。（剩余11757字）