摘要
目的·构建老年多发肋骨骨折患者发生肺部并发症的风险预测模型。方法·回顾性分析2016年1月至2017年12月期间上海交通大学医学院附属苏州九龙医院胸外科收治的150例老年多发肋骨骨折患者的资料。根据是否发生肺部并发症将患者分为病例组(n=88)和对照组(n=62)。结合性别、年龄、肺部基础疾病、吸烟史、肋骨骨折根数、咳痰情况、糖尿病、就诊时间等8项因素进行单因素分析及Logistic回归分析。结果·单因素分析结果显示:年龄、肺部基础疾病、吸烟史、肋骨骨折根数、咳痰情况、糖尿病、就诊时间等因素与发生肺部并发症有关(P<0.05)。Logistic回归分析结果显示:肺部基础疾病(OR=3.338,95%CI 2.772~11.606,P=0.003)、吸烟史(OR=2.407,95%CI 1.103~5.253,P=0.027)、肋骨骨折根数(OR=3.321,95%CI 1.178~9.359,P=0.023)、咳痰情况(OR=4.034,95%CI 1.818~8.952,P=0.001)是老年多发肋骨骨折患者发生肺部并发症的独立危险因素。构建模型的ROC曲线下面积为0.816,回归模型结果可靠。结论·肺部基础疾病、吸烟史、肋骨骨折根数、咳痰情况是老年多发肋骨骨折患者发生肺部并发症的独立危险因素,在临床上更应加以关注,以期减少肺部并发症的发生率。
Objective · To establish a risk prediction model for pulmonary complications in elderly patients with multiple rib fractures. Methods · A total of 150 cases of elderly patients with multiple rib fractures were analyzed retrospectively from January 2016 to December 2017 in the Department of Thoracic Surgery, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine. Patients were divided into case group(n=88) and control group(n=62) according to whether pulmonary complications occurred. Univariate analysis and Logistic regression analysis were performed based on 8 factors, including gender, age, basic pulmonary disease, smoking history, the number of rib fractures, expectoration, diabetes, and the treatment time. Results · The results of univariate analysis showed that age, basic pulmonary disease, smoking history, the number of rib fractures, expectoration,diabetes, and the treatment time were associated with pulmonary complications(P<0.05). Logistic regression analysis showed that basic pulmonary disease(OR=3.338, 95% CI 2.772-11.606, P=0.003), smoking history(OR=2.407, 95% CI 1.103-5.253, P=0.027), the number of rib fractures(OR=3.321, 95% CI1.178-9.359, P=0.023), and expectoration(OR=4.034, 95% CI 1.818-8.952, P=0.001) were the independent risk factors for pulmonary complications in elderly patients with multiple rib fractures. The area under the model ROC curve was 0.816, and the regression model was reliable. Conclusion · Basic pulmonary disease, smoking history, the number of rib fractures and expectoration are the independent risk factors for pulmonary complications in elderly patients with multiple rib fractures. More attention should be paid to these factors in order to reduce the incidence of pulmonary complications.
引文
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