Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures
Abstract Introduction New vertebral compression fractures (NVCFs) are adverse events after vertebral augmentation of osteoporotic vertebral compression fractures (OVCFs). Predicting the risk of vertebral compression fractures (VCFs) accurately after surgery is still a significant challenge for spina...
Guardado en:
| Autores principales: | , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
BMC
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/246769458ab44e51b728a30ac9021f0e |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:246769458ab44e51b728a30ac9021f0e |
|---|---|
| record_format |
dspace |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Osteoporosis vertebral compression fractures Vertebral augmentation New vertebral compression fractures Percutaneous vertebroplasty Percutaneous kyphoplasty Nomogram Diseases of the musculoskeletal system RC925-935 |
| spellingShingle |
Osteoporosis vertebral compression fractures Vertebral augmentation New vertebral compression fractures Percutaneous vertebroplasty Percutaneous kyphoplasty Nomogram Diseases of the musculoskeletal system RC925-935 Qiujiang Li Xingxia Long Yinbin Wang Xiaomin Fang Donggeng Guo Jinhan Lv Xuehua Hu Lijun Cai Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures |
| description |
Abstract Introduction New vertebral compression fractures (NVCFs) are adverse events after vertebral augmentation of osteoporotic vertebral compression fractures (OVCFs). Predicting the risk of vertebral compression fractures (VCFs) accurately after surgery is still a significant challenge for spinal surgeons. The aim of our study was to identify risk factors of NCVFs after vertebral augmentation of OVCFs and develop a nomogram. Methods We retrospectively reviewed the medical records of patients with OVCFs who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). Patients were divided into the NVCFs group and control group, base on the patients with or without NVCFs within 2 years follow-up period after surgery. A training cohort of 403 patients diagnosed in our hospital from June 2014 to December 2016 was used for model development. The independent predictive factors of postoperative VCFs were determined by least absolute shrinkage and selection operator (LASSO) logistic regression, univariate analysis and multivariate logistic regression analysis. We provided a nomogram for predicting the risk of NVCFs based on independent predictive factors and used the receiver operating characteristic curve (ROC), calibration curve, and decision curve analyses (DCA) to evaluated the prognostic performance. After internal validation, the nomogram was further evaluated in a validation cohort of 159 patients included between January 2017 and June 2018. Results Of the 403 patients in the training cohort, 49(12.16%) were NVCFs at an average of 16.7 (1 to 23) months within the 2 years follow-up period. Of the 159 patients in the validation cohort, 17(10.69%) were NVCFs at an average of 8.7 (1 to 15) months within the 2 years follow-up period. In the training cohort, the proportions of elderly patients older than 80 years were 32.65 and 13.56% in the NVCFs and control group, respectively (p = 0.003). The percentages of patients with previous fracture history were 26.53 and 12.71% in the NVCFs and control group, respectively (p = 0.010). The volume of bone cement were 4.43 ± 0.88 mL and 4.02 ± 1.13 mL in the NVCFs and Control group, respectively (p = 0.014). The differences have statistical significance in the bone cement leakage, bone cement dispersion, contact with endplate, anti-osteoporotic treatment, post-op Cobb angle and Cobb angle restoration characteristics between the two groups. The model was established by multivariate logistic regression analysis to obtain independent predictors. In the training and validation cohort, the AUC of the nomogram were 0.882 (95% confidence interval (CI), 0.824-0.940) and 0.869 (95% CI: 0.811-0.927), respectively. The C index of the nomogram was 0.886 in the training cohort and 0.893 in the validation cohort, demonstrating good discrimination. In the training and validation cohort, the optimal calibration curves demonstrated the coincidence between prediction and actual status, and the decision curve analysis demonstrated that the full model had the highest clinical net benefit across the entire range of threshold probabilities. Conclusion A nomogram for predicting NVCFs after vertebral augmentation was established and validated. For patients evaluated by this model with predictive high risk of developing postoperative VCFs, postoperative management strategies such as enhance osteoporosis-related health education and management should be considered. |
| format |
article |
| author |
Qiujiang Li Xingxia Long Yinbin Wang Xiaomin Fang Donggeng Guo Jinhan Lv Xuehua Hu Lijun Cai |
| author_facet |
Qiujiang Li Xingxia Long Yinbin Wang Xiaomin Fang Donggeng Guo Jinhan Lv Xuehua Hu Lijun Cai |
| author_sort |
Qiujiang Li |
| title |
Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures |
| title_short |
Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures |
| title_full |
Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures |
| title_fullStr |
Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures |
| title_full_unstemmed |
Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures |
| title_sort |
development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/246769458ab44e51b728a30ac9021f0e |
| work_keys_str_mv |
AT qiujiangli developmentandvalidationofanomogramforpredictingtheprobabilityofnewvertebralcompressionfracturesaftervertebralaugmentationofosteoporoticvertebralcompressionfractures AT xingxialong developmentandvalidationofanomogramforpredictingtheprobabilityofnewvertebralcompressionfracturesaftervertebralaugmentationofosteoporoticvertebralcompressionfractures AT yinbinwang developmentandvalidationofanomogramforpredictingtheprobabilityofnewvertebralcompressionfracturesaftervertebralaugmentationofosteoporoticvertebralcompressionfractures AT xiaominfang developmentandvalidationofanomogramforpredictingtheprobabilityofnewvertebralcompressionfracturesaftervertebralaugmentationofosteoporoticvertebralcompressionfractures AT donggengguo developmentandvalidationofanomogramforpredictingtheprobabilityofnewvertebralcompressionfracturesaftervertebralaugmentationofosteoporoticvertebralcompressionfractures AT jinhanlv developmentandvalidationofanomogramforpredictingtheprobabilityofnewvertebralcompressionfracturesaftervertebralaugmentationofosteoporoticvertebralcompressionfractures AT xuehuahu developmentandvalidationofanomogramforpredictingtheprobabilityofnewvertebralcompressionfracturesaftervertebralaugmentationofosteoporoticvertebralcompressionfractures AT lijuncai developmentandvalidationofanomogramforpredictingtheprobabilityofnewvertebralcompressionfracturesaftervertebralaugmentationofosteoporoticvertebralcompressionfractures |
| _version_ |
1718418993549672448 |
| spelling |
oai:doaj.org-article:246769458ab44e51b728a30ac9021f0e2021-11-21T12:27:52ZDevelopment and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures10.1186/s12891-021-04845-x1471-2474https://doaj.org/article/246769458ab44e51b728a30ac9021f0e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04845-xhttps://doaj.org/toc/1471-2474Abstract Introduction New vertebral compression fractures (NVCFs) are adverse events after vertebral augmentation of osteoporotic vertebral compression fractures (OVCFs). Predicting the risk of vertebral compression fractures (VCFs) accurately after surgery is still a significant challenge for spinal surgeons. The aim of our study was to identify risk factors of NCVFs after vertebral augmentation of OVCFs and develop a nomogram. Methods We retrospectively reviewed the medical records of patients with OVCFs who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). Patients were divided into the NVCFs group and control group, base on the patients with or without NVCFs within 2 years follow-up period after surgery. A training cohort of 403 patients diagnosed in our hospital from June 2014 to December 2016 was used for model development. The independent predictive factors of postoperative VCFs were determined by least absolute shrinkage and selection operator (LASSO) logistic regression, univariate analysis and multivariate logistic regression analysis. We provided a nomogram for predicting the risk of NVCFs based on independent predictive factors and used the receiver operating characteristic curve (ROC), calibration curve, and decision curve analyses (DCA) to evaluated the prognostic performance. After internal validation, the nomogram was further evaluated in a validation cohort of 159 patients included between January 2017 and June 2018. Results Of the 403 patients in the training cohort, 49(12.16%) were NVCFs at an average of 16.7 (1 to 23) months within the 2 years follow-up period. Of the 159 patients in the validation cohort, 17(10.69%) were NVCFs at an average of 8.7 (1 to 15) months within the 2 years follow-up period. In the training cohort, the proportions of elderly patients older than 80 years were 32.65 and 13.56% in the NVCFs and control group, respectively (p = 0.003). The percentages of patients with previous fracture history were 26.53 and 12.71% in the NVCFs and control group, respectively (p = 0.010). The volume of bone cement were 4.43 ± 0.88 mL and 4.02 ± 1.13 mL in the NVCFs and Control group, respectively (p = 0.014). The differences have statistical significance in the bone cement leakage, bone cement dispersion, contact with endplate, anti-osteoporotic treatment, post-op Cobb angle and Cobb angle restoration characteristics between the two groups. The model was established by multivariate logistic regression analysis to obtain independent predictors. In the training and validation cohort, the AUC of the nomogram were 0.882 (95% confidence interval (CI), 0.824-0.940) and 0.869 (95% CI: 0.811-0.927), respectively. The C index of the nomogram was 0.886 in the training cohort and 0.893 in the validation cohort, demonstrating good discrimination. In the training and validation cohort, the optimal calibration curves demonstrated the coincidence between prediction and actual status, and the decision curve analysis demonstrated that the full model had the highest clinical net benefit across the entire range of threshold probabilities. Conclusion A nomogram for predicting NVCFs after vertebral augmentation was established and validated. For patients evaluated by this model with predictive high risk of developing postoperative VCFs, postoperative management strategies such as enhance osteoporosis-related health education and management should be considered.Qiujiang LiXingxia LongYinbin WangXiaomin FangDonggeng GuoJinhan LvXuehua HuLijun CaiBMCarticleOsteoporosis vertebral compression fracturesVertebral augmentationNew vertebral compression fracturesPercutaneous vertebroplastyPercutaneous kyphoplastyNomogramDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-11 (2021) |