Can a Nomogram Predict the Failure Risk of Internal Fixation Devices in Chinese Patients Undergoing Hip Arthroplasty?

Abstract

Abstract Background:In order to achieve more accurate and personalized patient risk assessments and further understand the superposition effect of multiple risk factors, it is imperative to develop and validate a nomogram for the risk of failure of hip arthroplasty in Chinese patients. Methods:Data from 1198 patients who underwent hip arthroplasty in the First Affiliated Hospital of Guangxi Medical University from February 2012 to January 2021 were collected. Then, 1014 cases were assigned to the normal group and 184 cases to the failure group. Patients were further divided into training and verification tests. The risk assessment of failure for hip arthroplasty comprised 18 variables. In the training test, LASSO regression was applied to optimize the characteristics of revision hip arthroplasty. Lastly, significant variables in the LASSO regression analysis were included in the multivariate logistic regression analysis. Results:The C index was 0.715 (95% confidence interval: 0.667-0.763), and the area under the curve (AUC) was 0.715. Decision curve analysis illustrated that the predictive value of the nomogram was high, and its net income was between 0.06 and 0.4 or 0.51 to 0.69. Moreover, the C index of the validation test was 0.680. The parameters in the risk nomogram included body mass index (BMI), collar or collarless femoral stem, sparse trabecular bone, presence or absence of screws and the number of screws, history of diabetes, and occupation. Conclusion: The model had a satisfactory predictive ability. The higher the score, the higher the probability of failure. This will aid doctors in assessing the risk of failure of patients undergoing hip arthroplasty prior to the intervention.