Evaluation of a prediction model for the risk of acute urinary retention in elderly hip fracture patients in the Emergency Care
10.3760/cma.j.issn.1671-0282.2024.08.016
- VernacularTitle:急诊老年髋部骨折患者急性尿潴留风险预测模型与评价
- Author:
Ran BI
1
;
Xueqi LI
;
Lan GUAN
;
Zhaoxing TIAN
Author Information
1. 首都医科大学附属北京积水潭医院急诊科，北京 100035
- Keywords:
Elderly hip fracture;
Acute urinary retention;
Bladder volume;
Sedative hypnotics;
Dementia psychobehavioral symptoms;
Risk prediction;
Multivariate analysi
- From:
Chinese Journal of Emergency Medicine
2024;33(8):1172-1177
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establishing a clinical prediction model can assist clinicians in identifying at-risk patients early and intervening promptly to decrease AUR incidence.Methods:A retrospective collection of 313 elderly patients with hip fracture treated between 1st July and 31st August 2023 at the Emergency Department of our hospital. Patients were categorised into two groups: The AUR group (45 patients) and the non-AUR group (268 patients) based on the presence or absence of AUR. Basic characteristics, laboratory indicators and bladder volume were compared between the two groups. Factors independently associated with the incidence of AUR were analysed using Logistic regression. Analysis of the independent risk factors impacting the occurrence of AUR, development of a clinical prediction model for the risk of AUR in elderly patients with hip fractures, and internal validation of the model.Results:Comorbid psycho-behavioural symptoms of dementia ( OR=3.334, 95% CI 1.258-8.839, P=0.015), use of hypnotic sedatives ( OR=6.758, 95% CI 2.184-20.912, P=0. 001), increased heart rate ( OR=1.041, 95% CI 1.013-1.070, P=0.004), and increased bladder volume ( OR=1.005, 95% CI 1.004-1.007, P<0.01) were all identified as risk factors. The study identified independent risk factors for AUR in elderly patients who suffered a hip fracture. Based on these factors, the research team developed a prediction model which underwent internal validation using the Bootstrap method. The analysis indicated that the model’s prediction curves aligned closely with the standard model curves. The average absolute error was 0.021. The study's ROC results showed an AUC of 0.083 and a 95% CI of 0.767-0.909. Conclusions:Comorbid psycho-behavioural symptoms of dementia, the use of hypnotic sedative drugs, an increased heart rate, and an increased bladder volume are independent risk factors for the occurrence of AUR in elderly patients who have suffered a hip fracture. The creation of a chart prediction model using columns allows for a visual evaluation of the likelihood of AUR in elderly patients with hip fractures. This model provides important reference material for emergency physicians.
