Development of a prognostic model for 1-year survival after fragile hip fracture in Chinese

Journal of Orthopaedic Surgery and Research

Wei Qin¹  Bin Liang²  Qiang Liu³  Hairui Fu⁴  Xiaoxiong Qiao⁵ 

[1] Department of Medical Record Management, Affiliated Fenyang Hospital of Shanxi Medical University, 032200, Fenyang, China;Department of Orthopedics, Affiliated Fenyang Hospital of Shanxi Medical University, 032200, Fenyang, China;Department of Orthopedics, Third Hospital of Shanxi Medical University, 030032, Taiyuan, China;Department of Orthopedics, Third Hospital of Shanxi Medical University, 030032, Taiyuan, China;Department of Orthopedics, Affiliated Fenyang Hospital of Shanxi Medical University, 032200, Fenyang, China;Information Center, Affiliated Fenyang Hospital of Shanxi Medical University, 032200, Fenyang, China;

关键词: Prognostic model;    Development;    Fragile hip fracture;    Survival;   

DOI  :  10.1186/s13018-021-02774-y

来源: Springer

【 摘 要 】

BackgroundNo prognostic model for the survival of fragile hip fracture has been developed for Asians. The goal of this study was to develop a simple and practical prognostic model to predict survival within 1 year after fragile hip fracture in Asians.MethodsA single-center retrospective cohort study was designed. Under a multivariable Cox proportional hazards regression model, we used the preoperative characteristics of patients to predict survival within 1 year after hip fracture. We built a full model and then used the least absolute shrinkage and selection operator (LASSO) method to further shrink the model coefficients and achieved variable screening. Finally, we obtained a LASSO model. The model performance was evaluated with Nagelkerke’s R2 and the concordance (c) statistic. We assessed the internal validity with a bootstrapping procedure of 1 000 repetitions.ResultsA total of 735 eligible patients were admitted to our department for hip fracture from January 2015 to December 2020, but 11 (1.5%) patients were lost to follow-up. Among the remaining patients, 68 (9.3%) died within 1 year after hip fracture. We identified 12 candidate predictors from the preoperative characteristics of the patients. The last model contained nine predictors: surgery, age, albumin, sex, serum creatinine, malignancy, hypertension, ability to live independently, and cardiovascular and cerebrovascular diseases. Among them, surgery, age, and albumin are effective predictors of survival. The discrimination c statistic of the model is 0.814 (95% confidence interval 0.762–0.865); the corrected value through internal validation is 0.795.ConclusionsThis prognostic model can accurately predict a 1-year survival rate for patients with fragile hip fractures. This information can help clinicians develop a reasonable and personalized treatment plan.

【 授权许可】

CC BY