Establishment and validation of a predictive model for increased drainage volume after open transforaminal lumbar interbody fusion

HU Yin; YU Hai-long; GU Hong-wen; HAN Kang-en; TANG Shi-lei; ZHAO Yuan-hang; ZHANG Zhi-hao; LI Jun-chao; XING Le; WANG Hong-wei

doi:10.11659/jjssx.09E024033

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Establishment and validation of a predictive model for increased drainage volume after open transforaminal lumbar interbody fusion

Clinical Research | 更新时间：2025-11-25

- Establishment and validation of a predictive model for increased drainage volume after open transforaminal lumbar interbody fusion
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 11, Pages: 981-986(2025)
- 作者机构：
  
  1.大连医科大学研究生院，辽宁大连 116044
  2.北部战区总医院骨科，辽宁沈阳 110016
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.09E024033
  CLC： R687.3
- Received：06 September 2024，
  
  Published：25 November 2025
- 稿件说明：
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胡寅,于海龙,顾洪闻等.开放式经椎间孔腰椎椎间融合术后引流量增加的预测模型构建与验证[J].局解手术学杂志,2025,34(11):981-986.

HU Yin,YU Hai-long,GU Hong-wen,et al.Establishment and validation of a predictive model for increased drainage volume after open transforaminal lumbar interbody fusion[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):981-986.
胡寅,于海龙,顾洪闻等.开放式经椎间孔腰椎椎间融合术后引流量增加的预测模型构建与验证[J].局解手术学杂志,2025,34(11):981-986. DOI： 10.11659/jjssx.09E024033.

HU Yin,YU Hai-long,GU Hong-wen,et al.Establishment and validation of a predictive model for increased drainage volume after open transforaminal lumbar interbody fusion[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):981-986. DOI： 10.11659/jjssx.09E024033.

摘要

目的

分析开放式经椎间孔腰椎椎间融合术（TLIF）后引流量增加的危险因素，建立预测模型并进行验证。

方法

收集2016年1月至2019年12月于北部战区总医院行开放式TLIF的680例患者的临床资料，将患者随机分为训练组（

=476）和验证组（

=204），以

LASSO

回归分析筛选预测因素为自变量，构建多因素

Logistic

回归预测模型。通过受试者工作特征（

ROC

）曲线、

Hosmer

Lemeshow

拟合优度检验、校准曲线对模型进行内部验证，并使用决策曲线分析（

DCA

）判断其临床有效性。

结果

LASSO

回归分析筛选出4个预测变量：年龄、手术节段数量、手术持续时间和术中出血量。多因素

Logistic

回归预测模型显示，年龄≥60岁、手术节段数量≥4节、手术持续时间≥2 h和术中出血量≥200 mL是TLIF患者术后引流量增加的独立影响因素（

0.05）。

ROC

曲线分析显示，训练组的曲线下面积（

AUC

）为0.816（95%

：0.798~0.867）；验证组的

AUC

为0.783（95%

：0.685~0.823），表明预测模型具有良好的区分度。同时，

Hosmer

Lemeshow

拟合优度检验及校准曲线表明该模型具有较好的拟合度，预测概率与实际概率基本一致，具有较好的校准度。

DCA

结果显示，该预测模型可应用于临床。

结论

开放式TLIF术后引流量增加的危险因素包括年龄、手术节段数量、手术持续时间和术中出血量，以此构建的预测模型性能良好，可应用于临床指导TLIF术后引流管拔除时间的选择。

Abstract

Objective

To analyze the risk factors for increased drainage volume after open transforaminal lumbar interbody fusion （TLIF）， and to establish a predictive model and then validate it.

Methods

The clinical data of 680 patients who underwent open TLIF at the General Hospital of Northern Theater Command from January 2016 to December 2019 were collected and the patients were randomly divided into the training group （

=476） and the validation group （

=204）.Taking the predictive factors screened out by

LASSO

regression analysis as independent variables，a multivariate

Logistic

regression predictive model was constructed.The model was internally validated through the r

eceiver operating

characteristic

（

ROC

） curve，

Hosmer

Lemeshow

goodness-of-fit test， and calibration curve， and its clinical utility was assessed via

decision curve analysis

（

DCA

）.

Results

LASSO

regression analysis screened out four predictive variables：age，number of surgical segments， operative duration， and intraoperative blood loss. The multivariate

Logistic

regression predictive model demonstrated that age≥60 years， number of surgical segments≥4， operative duration≥2 hours， and intraoperative blood loss≥200 mL were independent influencing factors for the increased postoperative drainage volume in patients undergoing TLIF （

0.05）.

ROC

curve analysis revealed an

area under the curve

（

AUC

） of 0.816 （95%

： 0.798 to 0.867） in the training group and 0.783 （95%

： 0.685 to 0.823） in the validation group， indicating that the predictive model had good discriminatory ability.Additionally， the

Hosmer

Lemeshow

goodness-of-fit test and calibration curve indicated that the predictive model had a good degree of fit，and the predicted probability was basically consistent with the actual probability， demonstrating a good calibration.The

DCA

results confirmed

that this predictive model could be applied in clinical practice.

Conclusion

The risk factors for increased drainage volume after open TLIF include age， number of surgical segments， operative duration， and intraoperative blood loss. The predictive model established based on these factors demonstrates good performance， and it can be applied in clinical guidance for the selection of drainage tube removal time after TLIF.

关键词

Keywords

references

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