Construction of a predictive model for postoperative health-related quality of life decline in hip fracture patients
10.3760/cma.j.cn211501-20221112-03473
- VernacularTitle:髋部骨折患者术后健康相关生命质量下降的预测模型构建
- Author:
Xiaofei GUO
1
;
Shiguo YUAN
;
Shaoyan CHEN
;
Yehong XING
Author Information
1. 海南省中医院康复科，海口 570203
- Keywords:
Hip fracture;
Nomogram;
Health related quality of life;
Function
- From:
Chinese Journal of Practical Nursing
2023;39(31):2439-2445
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the health related quality of life (HRQoL) of hip fracture patients after surgery and build a prediction model to identify high-risk patients with HRQoL decline.Methods:A cross-sectional research method was applied to select 135 patients with unilateral hip fractures from January 2020 to June 2021 in Hainan Provincial Hospital of Traditional Chinese Medicine using convenience sampling as the study population. HRQoL was self-assessed using the European Five-Dimensional Health Scale (EQ-5D).Logistic regression models were used to identify risk factors for HRQoL decline. The columnar plots′ predictive accuracy and net clinical benefit were assessed using calibration curves, ROC curves, and decision curve analysis (DCA).Results:The final number of patients with valid follow-up was 122.At 6 and 12 months postoperatively, the EQ-5D index was lower than before the fracture in 41(33.6%) patients, showing a strong correlation with the Barthel index ( r=0.833, 0.705, both P<0.05). Nutritional Risk Screening 2002 (NRS-2002) ( OR=1.352), Charlson Comorbidity Index (CCI) ( OR=1.121), hip replacement ( OR=0.795), and lung infection ( OR=1.328) were independently associated with a decrease in HRQoL in patients with hip fracture (all P<0.05). The consistency index (C-index) of the column line plot was 0.889 (0.791 to 0.955), and the area under the curve (AUC) was 0.871 (0.784 to 0.947). The DCA results showed that the model provided good net clinical benefit. Conclusions:The model can effectively identify patients at high risk of declining HRQoL, which is helpful to determine priority patients to provide nursing strategies.
