Prediction model for an early revision for dislocation after primary total hip arthroplasty
Dislocation is one of the most common complications after primary total hip arthroplasty (THA). Several patient-related risk factors for dislocation have been reported in the previous literature, but only few prediction models for dislocation have been made. Our aim was to build a prediction model f...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462822/?tool=EBI |
| _version_ | 1798001016203902976 |
|---|---|
| author | Oskari Pakarinen Mari Karsikas Aleksi Reito Olli Lainiala Perttu Neuvonen Antti Eskelinen |
| author_facet | Oskari Pakarinen Mari Karsikas Aleksi Reito Olli Lainiala Perttu Neuvonen Antti Eskelinen |
| author_sort | Oskari Pakarinen |
| collection | DOAJ |
| description | Dislocation is one of the most common complications after primary total hip arthroplasty (THA). Several patient-related risk factors for dislocation have been reported in the previous literature, but only few prediction models for dislocation have been made. Our aim was to build a prediction model for an early (within the first 2 years) revision for dislocation after primary THA using two different statistical methods. The study data constituted of 37 pre- or perioperative variables and postoperative follow-up data of 16 454 primary THAs performed at our institution in 2008–2021. Model I was a traditional logistic regression model and Model II was based on the elastic net method that utilizes machine learning. The models’ overall performance was measured using the pseudo R2 values. The discrimination of the models was measured using C-index in Model I and Area Under the Curve (AUC) in Model II. Calibration curves were made for both models. At 2 years postoperatively, 95 hips (0.6% prevalence) had been revised for dislocation. The pseudo R2 values were 0.04 in Model I and 0.02 in Model II indicating low predictive capability in both models. The C-index in Model I was 0.67 and the AUC in Model II was 0.73 indicating modest discrimination. The prediction of an early revision for dislocation after primary THA is difficult even in a large cohort of patients with detailed data available because of the reasonably low prevalence and multifactorial nature of dislocation. Therefore, the risk of dislocation should be kept in mind in every primary THA, whether the patient has predisposing factors for dislocation or not. Further, when conducting a prediction model, sophisticated methods that utilize machine learning may not necessarily offer significant advantage over traditional statistical methods in clinical setup. |
| first_indexed | 2024-04-11T11:29:20Z |
| format | Article |
| id | doaj.art-69d14f0a3f4b427fb0a3a7b5c8527e28 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T11:29:20Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-69d14f0a3f4b427fb0a3a7b5c8527e282022-12-22T04:26:11ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01179Prediction model for an early revision for dislocation after primary total hip arthroplastyOskari PakarinenMari KarsikasAleksi ReitoOlli LainialaPerttu NeuvonenAntti EskelinenDislocation is one of the most common complications after primary total hip arthroplasty (THA). Several patient-related risk factors for dislocation have been reported in the previous literature, but only few prediction models for dislocation have been made. Our aim was to build a prediction model for an early (within the first 2 years) revision for dislocation after primary THA using two different statistical methods. The study data constituted of 37 pre- or perioperative variables and postoperative follow-up data of 16 454 primary THAs performed at our institution in 2008–2021. Model I was a traditional logistic regression model and Model II was based on the elastic net method that utilizes machine learning. The models’ overall performance was measured using the pseudo R2 values. The discrimination of the models was measured using C-index in Model I and Area Under the Curve (AUC) in Model II. Calibration curves were made for both models. At 2 years postoperatively, 95 hips (0.6% prevalence) had been revised for dislocation. The pseudo R2 values were 0.04 in Model I and 0.02 in Model II indicating low predictive capability in both models. The C-index in Model I was 0.67 and the AUC in Model II was 0.73 indicating modest discrimination. The prediction of an early revision for dislocation after primary THA is difficult even in a large cohort of patients with detailed data available because of the reasonably low prevalence and multifactorial nature of dislocation. Therefore, the risk of dislocation should be kept in mind in every primary THA, whether the patient has predisposing factors for dislocation or not. Further, when conducting a prediction model, sophisticated methods that utilize machine learning may not necessarily offer significant advantage over traditional statistical methods in clinical setup.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462822/?tool=EBI |
| spellingShingle | Oskari Pakarinen Mari Karsikas Aleksi Reito Olli Lainiala Perttu Neuvonen Antti Eskelinen Prediction model for an early revision for dislocation after primary total hip arthroplasty PLoS ONE |
| title | Prediction model for an early revision for dislocation after primary total hip arthroplasty |
| title_full | Prediction model for an early revision for dislocation after primary total hip arthroplasty |
| title_fullStr | Prediction model for an early revision for dislocation after primary total hip arthroplasty |
| title_full_unstemmed | Prediction model for an early revision for dislocation after primary total hip arthroplasty |
| title_short | Prediction model for an early revision for dislocation after primary total hip arthroplasty |
| title_sort | prediction model for an early revision for dislocation after primary total hip arthroplasty |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9462822/?tool=EBI |
| work_keys_str_mv | AT oskaripakarinen predictionmodelforanearlyrevisionfordislocationafterprimarytotalhiparthroplasty AT marikarsikas predictionmodelforanearlyrevisionfordislocationafterprimarytotalhiparthroplasty AT aleksireito predictionmodelforanearlyrevisionfordislocationafterprimarytotalhiparthroplasty AT ollilainiala predictionmodelforanearlyrevisionfordislocationafterprimarytotalhiparthroplasty AT perttuneuvonen predictionmodelforanearlyrevisionfordislocationafterprimarytotalhiparthroplasty AT anttieskelinen predictionmodelforanearlyrevisionfordislocationafterprimarytotalhiparthroplasty |