A Nomogram to Predict Intra-Spinal Canal Cement Leakage Among Elderly Patients with Spine Metastases: An Internal-Validated Model

Xuedong Shi,1,* Yunpeng Cui,1,* Yuanxing Pan,1 Bing Wang,1 Mingxing Lei2,3 1Department of Orthopedic Surgery, Peking University First Hospital, Beijing, 100032, People’s Republic of China; 2Department of Orthopedic Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, People’s Republic of China; 3Chinese PLA Medical School, Beijing, 100853, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xuedong ShiDepartment of Orthopedic Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100032, People’s Republic of ChinaTel +86 10-83572211Email 172998774qq.com; xuedongs@hotmail.comMingxing LeiDepartment of Orthopedic Surgery, Hainan Hospital of Chinese PLA General Hospital, Jianglin Road, Haitang District, Sanya, 572013, People’s Republic of ChinaTel +86-18811772189Email 825979020@qq.comPurpose: This study aimed to assess the risk variables for predicting intra-spinal canal cement leakage, especially among elderly patients with spine metastases after being treated with percutaneous vertebroplasty (PVP). Furthermore, we proposed and validated a nomogram to stratify risks of intra-spinal canal cement leakage.Methods: We retrospectively analyzed 163 elderly patients (age ≧65 years) with spine metastases who underwent PVP. Patients were randomly divided into a training cohort (n=100) and a validation cohort (n=63). The multivariate logistic regression analysis was used to screen potential risk variables in the training cohort. Significant risk variables were included in the nomogram, and the nomogram was developed according to the estimates of the each included variable. The predictive effectiveness of the nomogram was validated using discrimination and calibration performance.Results: The overall prevalence of intra-spinal canal cement leakage was 9.82% (16/163). In the training cohort, female patients (14.71%, 5/34) showed a higher rate of intra-spinal canal cement leakage as compared with male patients (4.55%, 3/66). The nomogram consisted of sex, cortical osteolytic destruction in posterior wall, and load-bearing lines of spine. The nomogram had acceptable discrimination, with the area under the receiver operating characteristic (AUROC) of 0.75 in the training cohort, 0.64 in the validation cohort, and 0.69 in the entire cohort, and also showed favorable calibration based on the goodness-of-fit test. According to the nomogram, three risk groups were developed: the low risk group had an actual probability of 7.03%, the medium risk group was 11.54%, and high risk group was 44.44%. The difference between the three groups was significant (P ˂ 0.01).Conclusion: Intra-spinal canal cement leakage after PVP is not scarce among elderly patients. We proposed and internally validated a nomogram that is capable of calculating the risk of intra-spinal canal cement leakage among elderly patients with spine metastases. Careful surgical plan should be conducted among patients with a high risk of developing intra-spinal canal cement leakage.Keywords: elderly patients, spine metastases, percutaneous vertebroplasty, cement leakage, nomogram.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - year:2021

Enthalten in:

Clinical Interventions in Aging - (2021), Seite 1735-1746

Sprache:

Englisch

Beteiligte Personen:

Shi X [VerfasserIn]
Cui Y [VerfasserIn]
Pan Y [VerfasserIn]
Wang B [VerfasserIn]
Lei M [VerfasserIn]

Links:

doaj.org [kostenfrei]
www.dovepress.com [kostenfrei]
Journal toc [kostenfrei]

Themen:

Cement leakage
Elderly patients
Geriatrics
Nomogram
Percutaneous vertebroplasty
Spine metastases

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

DOAJ063213249