Development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fracture
Abstract Background This study aimed to develop and validate an individualized nomogram to predict the risk of positive hidden blood loss (HBL) in patients with single-level thoracolumbar burst fracture (TBF) during the perioperative period. Methods We conducted a retrospective investigation includi...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2021-09-01
|
Series: | Journal of Orthopaedic Surgery and Research |
Subjects: | |
Online Access: | https://doi.org/10.1186/s13018-021-02699-6 |
id |
doaj-63dd646dcb99434fb288b7eb3cd4bf0f |
---|---|
record_format |
Article |
spelling |
doaj-63dd646dcb99434fb288b7eb3cd4bf0f2021-09-19T11:41:52ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-09-0116111210.1186/s13018-021-02699-6Development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fractureHaosheng Wang0Tingting Fan1Zhi-Ri Tang2Wenle Li3Linjing Liu4Qiang Lin5Department of Orthopedics, Baoji City Hospital of Traditional Chinese MedicineDepartment of Endocrinology, Baoji City Hospital of Traditional Chinese MedicineDepartment of Computer Science, City University of Hong KongDepartment of Orthopedics, Xianyang Central HospitalDepartment of Computer Science, City University of Hong KongDepartment of Orthopedics, Baoji City Hospital of Traditional Chinese MedicineAbstract Background This study aimed to develop and validate an individualized nomogram to predict the risk of positive hidden blood loss (HBL) in patients with single-level thoracolumbar burst fracture (TBF) during the perioperative period. Methods We conducted a retrospective investigation including 150 consecutive patients with TBL, and the corresponding patient data was extracted from March 2013 to March 2019. The independent risk factors for positive HBL were screened using univariate and multivariate logistic regression analyses. According to published literature and clinical experience, a series of variables were selected to develop a nomogram prediction model for positive HBL. The area under the receiver operating characteristic curves (AUC), C-index, calibration plot, and decision curve analysis (DCA) were used to evaluate the performance of the prediction model. Bootstrapping validation was performed to evaluate the performance of the model. Results Among the 150 consecutive patients, 62 patients were positive for HBL (38.0%). The multivariate logistic regression analysis showed that the six risk factors of age, length of surgical incision, duration of operation, percentage of vertebral height restoration (P1%), preoperative total cholesterol, and preoperative fibrinogen were independent risk factors of positive HBL. The C-index was 0.831 (95% CI 0.740–0.889) and 0.845 in bootstrapping validation, respectively. The calibration curve showed that the predicted probability of the model was consistent with the actual probability. Decision curve analysis (DCA) showed that the nomogram had clinical utility. Conclusion Overall, we explored the relationship between the positive HBL requirement and predictors. The individualized prediction model for patients with single-level TBF can accurately assess the risk of positive HBL and facilitate clinical decision making. However, external validation will be needed in the future.https://doi.org/10.1186/s13018-021-02699-6Hidden blood lossBlood lossThoracolumbar burst fractureRisk factorsNomogram |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Haosheng Wang Tingting Fan Zhi-Ri Tang Wenle Li Linjing Liu Qiang Lin |
spellingShingle |
Haosheng Wang Tingting Fan Zhi-Ri Tang Wenle Li Linjing Liu Qiang Lin Development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fracture Journal of Orthopaedic Surgery and Research Hidden blood loss Blood loss Thoracolumbar burst fracture Risk factors Nomogram |
author_facet |
Haosheng Wang Tingting Fan Zhi-Ri Tang Wenle Li Linjing Liu Qiang Lin |
author_sort |
Haosheng Wang |
title |
Development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fracture |
title_short |
Development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fracture |
title_full |
Development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fracture |
title_fullStr |
Development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fracture |
title_full_unstemmed |
Development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fracture |
title_sort |
development and validation of a nomogram for prediction of the risk of positive hidden blood loss in the perioperative period of single-level thoracolumbar burst fracture |
publisher |
BMC |
series |
Journal of Orthopaedic Surgery and Research |
issn |
1749-799X |
publishDate |
2021-09-01 |
description |
Abstract Background This study aimed to develop and validate an individualized nomogram to predict the risk of positive hidden blood loss (HBL) in patients with single-level thoracolumbar burst fracture (TBF) during the perioperative period. Methods We conducted a retrospective investigation including 150 consecutive patients with TBL, and the corresponding patient data was extracted from March 2013 to March 2019. The independent risk factors for positive HBL were screened using univariate and multivariate logistic regression analyses. According to published literature and clinical experience, a series of variables were selected to develop a nomogram prediction model for positive HBL. The area under the receiver operating characteristic curves (AUC), C-index, calibration plot, and decision curve analysis (DCA) were used to evaluate the performance of the prediction model. Bootstrapping validation was performed to evaluate the performance of the model. Results Among the 150 consecutive patients, 62 patients were positive for HBL (38.0%). The multivariate logistic regression analysis showed that the six risk factors of age, length of surgical incision, duration of operation, percentage of vertebral height restoration (P1%), preoperative total cholesterol, and preoperative fibrinogen were independent risk factors of positive HBL. The C-index was 0.831 (95% CI 0.740–0.889) and 0.845 in bootstrapping validation, respectively. The calibration curve showed that the predicted probability of the model was consistent with the actual probability. Decision curve analysis (DCA) showed that the nomogram had clinical utility. Conclusion Overall, we explored the relationship between the positive HBL requirement and predictors. The individualized prediction model for patients with single-level TBF can accurately assess the risk of positive HBL and facilitate clinical decision making. However, external validation will be needed in the future. |
topic |
Hidden blood loss Blood loss Thoracolumbar burst fracture Risk factors Nomogram |
url |
https://doi.org/10.1186/s13018-021-02699-6 |
work_keys_str_mv |
AT haoshengwang developmentandvalidationofanomogramforpredictionoftheriskofpositivehiddenbloodlossintheperioperativeperiodofsinglelevelthoracolumbarburstfracture AT tingtingfan developmentandvalidationofanomogramforpredictionoftheriskofpositivehiddenbloodlossintheperioperativeperiodofsinglelevelthoracolumbarburstfracture AT zhiritang developmentandvalidationofanomogramforpredictionoftheriskofpositivehiddenbloodlossintheperioperativeperiodofsinglelevelthoracolumbarburstfracture AT wenleli developmentandvalidationofanomogramforpredictionoftheriskofpositivehiddenbloodlossintheperioperativeperiodofsinglelevelthoracolumbarburstfracture AT linjingliu developmentandvalidationofanomogramforpredictionoftheriskofpositivehiddenbloodlossintheperioperativeperiodofsinglelevelthoracolumbarburstfracture AT qianglin developmentandvalidationofanomogramforpredictionoftheriskofpositivehiddenbloodlossintheperioperativeperiodofsinglelevelthoracolumbarburstfracture |
_version_ |
1717375608407719936 |