Construction Of Clinical Prediction Model Of Percutaneous Kyphoplasty For Stage Ⅱ Kümmell’s Disease Based On The Theory Of "Prevention Of Disease"

Objective: Based on the theory of " prevention of disease " and the method of clinical prediction model,a clinical prediction model of percutaneous kyphoplasty(PKP)for the treatment of stage II Kümmell’s disease was constructed and presented in the form of nomogram,which enables clinicians to identify high-risk population,predict disease outcome and avoid the occurrence of postoperative adverse events through the preoperative data of patients,and provides a reference for the selection of clinical treatment options.Methods: According to the inclusion criteria,the clinical data of patients with stageⅡ Kümmell disease treated by PKP in the orthopedic ward of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2020 to January 2022 were selected.Lasso regression and Logistic regression were used to analyze the independent risk factors of poor curative effect,and R software(R4.1.2)and RMS software package were used to build a nomogram prediction model,and the area under ROC curve was calculated by the predicted value,and bootstrap method was used to simulate sampling for internal verification,and C-index was calculated.Finally,the corrected curve was compared with the actual curve.Results: Logistic regression analysis showed that VAS score(OR=6.67,95%CI=1.63-15.25),adjacent vertebra fracture(OR=2.46,95%CI=1.90-6.70)and adjacent vertebra wedge-shaped change(OR =4.59,95% CI).95%CI=1.16-22.33)and BMD(OR=0.29,95%CI=0.27-0.45)are independent risk factors for poor efficacy of PKP.Based on the above five risk factors,the related nomogram prediction model is established,and the area under ROC curve is AUC=0.977,which shows that the model has good discrimination.Bootstrap method is used to simulate sampling for 1000 times,and the correction C-index is 0.965,and the actual curve is very close to the correction curve,which shows that the model has good prediction ability and accuracy.Conclusion: The nomogram based on VAS score,whether the adjacent vertebrae are fractured,whether the adjacent vertebrae are wedge-shaped,whether the height of the anterior vertebral body is greater than the height of the posterior vertebral body,and BMD has good predictive efficacy and clinical value for PKP in the treatment of stage Ⅱ Kümmell’s disease.