International Journal of General Medicine (Apr 2022)

Prediction Models for Prognosis of Femoral Neck–Fracture Patients 6 Months after Total Hip Arthroplasty

  • Zheng X,
  • Xiao C,
  • Xie Z,
  • Liu L,
  • Chen Y

Journal volume & issue
Vol. Volume 15
pp. 4339 – 4356

Abstract

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Xiaofeng Zheng,1,* Cong Xiao,1,* Zhuocheng Xie,2 Lijuan Liu,1 Yinhua Chen1 1Department of Orthopedics, Third Hospital of Mianyang Sichuan Mental Health Center, Mianyang, Sichuan, 621000, People’s Republic of China; 2Department of Orthopedics, Sichuan Science City Hospital, Mianyang, Sichuan, 621000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yinhua Chen, Department of Orthopedics, Third Hospital of Mianyang Sichuan Mental Health Center, 190 East Jiannan Road, Youxian, Mianyang, Sichuan, 621000, People’s Republic of China, Tel +86-139-9014-7729, Email [email protected]: To establish prediction models for 6-month prognosis in femoral neck–fracture patients receiving total hip arthroplasty (THA).Patients and Methods: In total, 182 computed tomography image pairs from 85 patients were collected and divided into a training set (n=127) and testing set (n=55). Least absolute shrinkage–selection operator regression was used for selecting optimal predictors. A random-forest algorithm was used to establish the prediction models, which were evaluated for accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC).Results: The best model in this study was constructed based on demographic data, preoperative laboratory indicators, and three preoperative radiomic features. In the random-forest model, activated partial thromboplastin time, a preoperative radiomic feature (maximum diameter), and fibrinogen were important variables correlating with patient outcomes. The AUC, sensitivity, specificity, PPV, NPV, and accuracy in the training set were 0.986 (95% CI 0.971– 1), 0.925 (95% CI 0.862– 0.988), 0.983 (95% CI 0.951– 1.016), 0.984 (95% CI 0.953– 1.014), 0.922 (95% CI 0.856– 0.988), and 0.953 (95% CI 0.916– 0.990), respectively. The AUC, sensitivity, specificity, PPV, NPV, and accuracy in the testing set were 0.949 (95% CI 0.885– 1), 0.767 (95% CI 0.615– 0.918), 1 (95% CI 1– 1), 1 (95% CI 1– 1), 0.781 (95% CI 0.638– 0.924), and 0.873 (95% CI 0.785– 0.961), respectively.Conclusion: The model based on demographic, preoperative clinical, and preoperative radiomic data showed the best predictive ability for 6-month prognosis in the femoral neck–fracture patients receiving THA.Keywords: prediction model, total hip arthroplasty, computed tomography, prognosis, femoral neck fracture

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