Establishment And Verification Of A Nomogram For Predicting The Risk Of Hip Fracture In Osteoporotic Population Based On Blood Biochemical Indicators And Hip Bone Characteristics

Objective:Osteoporosis(OP)is a very common disease in the middle-aged and elderly population,among which Hip fracture,(HF)HF is its common and the most serious consequence.Among people over 65 years of age,HF accounts for 23.79% of total fractures,which is called the last fracture in life,with the disability rate of 50% within one year of HF occurrence,and the high morality rate of 15%-33%.Due to the high morbidity and mortality of HF,it is necessary to identify the risk factors for HF and predict the risk of HF,and our aim is to establish and validate the Nomogram model to predict the risk of HF in the osteoporosis population.Method:In the Donghua database of the Affiliated Hospital of Chengde Medical College,the general and clinical data of 398 OP patients with a clear history of trauma and underwent orthotopic and blood biochemical examinations from June 2019 to June 2020 were collected and screened,including: gender,age,Mean Femoral neck length(FNL),Mean Femoral shaft diameter(FSD),Mean Femoral cortical thickness(FCT),Cholesterol(CHOL),Triglycerides(TG),Low-density lipoprotein cholesterol,LDL-c,High-density lipoprotein cholesterol(HDL-c),Serum calcium(Ca),Serum magnesium(Mg),Inorganic phosphorus(IP),with the caret package of Software R,the population included in the study was randomly divided into the training group and the validation group in a ratio of 7:3.The training group was used for the construction and validation of the Nomogram,and the validation group was used for the validation of the Nomogram.Univariate logistic regression was used to determine the risk factors for HF risk,multivariate logistic regression was used to determine its independent risk factors,based on the independent risk factors,Software R was to build the Nomogram of HF risk of OP patient,calibration curve,receiver operating characteristics(ROC)curve and Decision Curve Analysis(DCA)were used for validation.Result:Of the 398 researchers,258(64.8%)were diagnosed with HF.Through univariate,multivariate logistic regression analysis,we determined that age,serum calcium concentration,the mean femoral neck length,mean femoral shaft diameter,and mean femoral cortical thickness were independent risk factors for HF in OP patients,on the basis of independent risk factors,a Nomogram was constructed to predict HF risk in OP people.Area under the curve(AUC)in the training group and the validation group are 0.998 and0.990 respectively,the calibration curve reflects the good agreement between the prediction results and the model,and the clinical decision curve reflects the high clinical application value of the Nomogram.Conclusion:The Nomogram established according to the independent risk factors of patients has a good ability in predicting the risk of HF in the OP patients.Clinicians can provide the basis for the individualized diagnosis and treatment of patients and improve the treatment plan according to this model.