老年患者髋关节置换术后低蛋白血症危险因素分析及预测模型构建

陈久太; 张旺; 方雪; 黄承; 董嘉怡; 柳昌焕; 王欣

doi:10.14188/j.1671-8852.2025.0614

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老年患者髋关节置换术后低蛋白血症危险因素分析及预测模型构建

临床医学研究 | 更新时间：2026-11-06

- 老年患者髋关节置换术后低蛋白血症危险因素分析及预测模型构建
- Analysis of risk factors for hypoproteinemia after hip arthroplasty in elderly patients and construction of a prediction model
- 武汉大学学报（医学版） 2025年46卷第12期页码：1621-1626
- 作者机构：
  
  1.武汉大学中南医院，关节与运动医学科，湖北武汉 430071
  2.武汉大学中南医院，创伤与显微骨科/老年髋部骨折诊疗中心，湖北武汉 430071
- 作者简介：
  
  陈久太，男，1994—，护师，主要从事骨科临床护理研究， E‑mail：chenjiutai@znhsopital.cn
  王欣，男，1969—，医学博士，主任医师，主要从事骨科疾病相关研究，E‑mail：wangxinznyy@whu.edu.cn
- 基金信息：
  
  湖北省骨外科学科能力建设项目(YYXKNL2022009)
- DOI：10.14188/j.1671-8852.2025.0614
  中图分类号： R683.42
- 收稿：2025-06-15，
  
  纸质出版：2025-12-25
- 稿件说明：
移动端阅览
陈久太,张旺,方雪等.老年患者髋关节置换术后低蛋白血症危险因素分析及预测模型构建[J].武汉大学学报（医学版）,2025,46(12):1621-1626.

CHEN Jiutai,ZHANG Wang,FANG Xue,et al.Analysis of risk factors for hypoproteinemia after hip arthroplasty in elderly patients and construction of a prediction model[J].Medical Journal of Wuhan University,2025,46(12):1621-1626.
陈久太,张旺,方雪等.老年患者髋关节置换术后低蛋白血症危险因素分析及预测模型构建[J].武汉大学学报（医学版）,2025,46(12):1621-1626. DOI： 10.14188/j.1671-8852.2025.0614.

CHEN Jiutai,ZHANG Wang,FANG Xue,et al.Analysis of risk factors for hypoproteinemia after hip arthroplasty in elderly patients and construction of a prediction model[J].Medical Journal of Wuhan University,2025,46(12):1621-1626. DOI： 10.14188/j.1671-8852.2025.0614.

摘要

目的

分析老年患者髋关节置换术后发生低蛋白血症的危险因素，并建立一个预测模型，以尽早识别发生低蛋白血症的高危患者，在临床上为老年患者髋关节置换术后低蛋白血症的预防提供重要参考。

方法

采用回顾性研究方法，收集2019年9月至2023年9月在武汉大学中南医院行髋关节置换手术的190例患者资料，通过Logistic回归模型分析老年患者髋关节置换术后发生低蛋白血症的危险因素，并建立预测模型，绘制并计算受试者工作特征（ROC）曲线下面积（

AUC

），评价模型的预测能力。

结果

单因素分析显示低蛋白血症与非低蛋白血症组比较，术前白蛋白、术前血沉、术中输血量、术中出血量、手术当天补液量、手术时长差异有统计学意义（均

0.05）。Logistic回归分析显示术前白蛋白、术中输血量、术中出血量、手术当天补液量是老年患者髋关节置换术后发生低蛋白血症的独立危险因素（

0.05），基于以上四个指标建立预测模型，并使用R软件绘制出预测模型列线图，该预测模型的

AUC

为0.852（95%

：0.776~0.929），预测模型的Hosmer‑Lemeshow拟合优度检验结果显示模型预测值与实际观测值之间差异无统计学意义（Hosmer‑Lemeshow

=9.939

=0.269），由此说明该模型的预测能力较好。

结论

术前白蛋白、术中输血量、术中出血量、手术当天补液量是老年患者髋关节置换术后发生低蛋白血症的独立危险因素，建立的预测模型具有良好的预测能力，在临床上可为老年患者髋关节置换术后低蛋白血症的预防提供重要参考。

Abstract

Objective

To analyze the risk factors for hypoalbuminemia occurring after hip arthroplasty in elderly patients and to establish a predictive model for early identification of high⁃risk patients

providing important clinical references for its prevention.

Methods

A retrospective study was conducted in which data were collected from 190 patients who underwent hip arthroplasty at Zhongnan Hospital of Wuhan University from September 2019 to September 2023. Logistic regression analysis was performed to identify risk factors for hypoalbuminemia after hip arthroplasty in elderly patients and to establish a predictive model. The area under the receiver operating characteristic (ROC) curve (

AUC

) was calculated to evaluate the predictive ability of the

model.

Results

Univariate analysis showed that there were statistically significant differences between hypoalbuminemia group and the non⁃hypoalbuminemia group in preoperative albumin

preoperative erythrocyte sedimentation rate

intraoperative blood transfusion volume

intraoperative blood loss

postoperative day 1 fluid volume

and duration of surgery (all

0.05). Logistic regression analysis indicated that preoperative albumin

intraoperative blood transfusion volume

intraoperative blood loss

and postoperative day 1 fluid volume were independent risk factors for hypoalbuminemia after hip arthroplasty in elderly patients (

0.05). A prediction model was established based on these four indicators

and a nomogram for the prediction model was created using R software. The

AUC

of the prediction model was 0.852 (95%

: 0.776⁃0.929)

and the Hosmer‑Lemeshow goodness‑of‑fit test showed no statistically significant difference between the predicted values and observed values (

²=9.939

=0.269)

indicating good predictive ability of the model.

Conclusion

Preoperative albumin

intraoperative blood transfusion volume

intraoperative blood loss

and fluid volume on the day of surgery are independent risk factors for hypoalbuminemia after hip arthroplasty in elderly patients. The established prediction model demonstrates good predictive ability and can provide important guidance for preventing hypoalbuminemia in this population.

关键词

Keywords

references

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