A systematic review of prediction models for postoperative mortality risk in elderly patients with hip fracture
10.3760/cma.j.cn115682-20230505-01745
- VernacularTitle:老年髋部骨折患者术后死亡风险预测模型的系统评价
- Author:
Congyang LI
1
;
Li LI
;
Xiangfeng CHEN
Author Information
1. 安徽医科大学附属六安医院骨科，六安 237000
- Keywords:
Aged;
Hip fracture;
Femoral neck fracture;
Femoral intertrochanteric fracture;
Postoperative death;
Prediction model;
Systematic review
- From:
Chinese Journal of Modern Nursing
2024;30(6):735-742
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically review the prediction models of postoperative mortality risk in elderly patients with hip fracture.Methods:China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine disc, PubMed, Embase, Cochrane Library and Web of Science were systematically searched for studies on mortality risk prediction models after hip fracture surgery in the elderly. The search period was from establishment of the databases to February 28, 2023. Two researchers independently screened the literature, extracted the data, and used the predictive model risk bias tool to evaluate the quality of studies. R4.1.1 software was used to perform meta-analysis of the data.Results:A total of 15 studies were included, of which five were for model development and ten were for model development and internal validation. The performance of the prediction models in the 15 studies was generally good ( AUC: 0.640-0.967), but all of them had bias risks, mainly due to the small sample size, unreported processing methods for missing data values, data complexity, the inappropriate screening method of predictor variables and the lack of consideration of model fitting. Meta-analysis showed that age increase [ OR=1.06, 95% CI (1.04, 1.08), P<0.01], male [ OR=1.92, 95% CI (1.48, 2.48), P<0.01] and reduced hemoglobin [ OR=1.53, 95% CI (1.35, 1.74), P<0.01] were independent risk factors for postoperative death in elderly patients with hip fracture. Conclusions:The prediction model of mortality risk after hip fracture surgery in elderly patients still has shortcomings. In the future, it is necessary to optimize the existing model and verify the model internally and externally. Medical staff should focus on elderly, male, postoperative patients with low hemoglobin and formulate targeted intervention strategies in advance.
