Establishment and verification of postoperative 1-year mortality risk prediction model in elderly patients undergoing hip fracture surgery
10.3760/cma.j.cn131073.20210627.00809
- VernacularTitle:髋部骨折手术老年患者术后1年死亡风险预测模型的建立与验证
- Author:
Yaozhi CHEN
1
;
Yingfeng ZHOU
;
Lingfei PU
;
Xutong ZHANG
;
Kaiming YUAN
;
Jun LI
Author Information
1. 温州医科大学附属第二医院 育英儿童医院麻醉与围术期医学科 325027
- Keywords:
Hip fracture;
Aged;
Forecasting;
Death;
Postoperative complications
- From:
Chinese Journal of Anesthesiology
2021;41(8):933-938
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a prediction model of postoperative 1-year mortality risk in elderly patients undergoing hip fracture surgery and verify its efficacy.Methods:Patients of both sexes, aged ≥65 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅳ, who underwent an operation for traumatic hip fracture in the Second Affiliated Hospital of Wenzhou Medical University from January 2017 to December 2018, were enrolled and randomly assigned to model group and verification group in a ratio of 3∶1.The demographic characteristics, clinical data and results such as laboratory examinations were collected.In model group, the logistic regression analysis was used to recognize the independent risk factors for 1-year mortality after procedure, and the prediction model was established.In verification group, the prediction efficacy was analyzed using the receiver operating characteristic curve, and the degree of fitting was evaluated by Hosmer-Lemeshow goodness-of-fit test.Results:Multivariate logistic analysis indicated that age ≥84 yr, Charlson comorbidity index ≥2 points, Braden score on admission to hospital ≤16 points, preoperative urea nitrogen ≥8.8 mmol/L and postoperative albumin ≤ 29.6 g/L were the independent risk factors for 1-year mortality after hip fracture surgery in elderly patients ( P<0.05). The prediction model was established based on the risk factors mentioned above.The area under receiver operating characteristic curve was 0.870, and the sensitivity and specificity were 82.8% and 80.0%, respectively.The prediction model showed good fitting ( χ2=4.672, P=0.700). Conclusion:Age ≥84 yr, Charlson comorbidity index ≥2 points, Braden score on admission to hospital≤16 points, preoperative urea nitrogen ≥8.8 mmol/L and postoperative albumin ≤ 29.6 g/L are the independent risk factors for 1-year mortality after hip fracture surgery in elderly patients, and the prediction model established based on the above indicators has good efficacy.
