Development and validation of survival prediction model for one-year mortality after surgery for intertrochanteric fractures in elderly patients
Objective To investigate the risk factors associated with one-year mortality following surgery for intertrochanteric fractures in elderly patients and develop a survival prediction model.Methods A retrospective analysis was conducted on clinical data from 532 elderly patients with intertrochanteric fractures admitted to the People's Hospital of Xinjiang Uygur Autonomous Region and the People's Hospital of Xinyang between January 2020 and September 2022.Patient demographics,laboratory indicators,and surgical variables were documented.The primary outcome assessed was the one-year mortality rate.Risk factors were identified through univariate and multivariate Cox regression analyses,leading to the development of a prognostic model.The model's predictive performance was evaluated using the Concordance Index(C-Index),time-dependent receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results Multivariate Cox regression analysis identified several key factors associated with one-year mortality after intertrochanteric fractures in elderly patients.These factors included the modified five-item frailty index(OR=1.338,95％CI:1.147-1.561,P＜0.001),ICU admission(OR=1.694,95％CI:1.230-2.333,P=0.001),.preoperative hemoglobin levels(OR=1.281,95％CI:1.016-1.616,P=0.036),surgical waiting time(OR=1.570,95％CI:1.063-2.319,P=0.023),and age(OR=2.196,95％CI:1.712-2.816,P＜0.001).The prediction model showed good consistency with a C-Index of 0.769(95％CI:0.723-0.818)in the modeling group and 0.715(95％CI:0.612-0.750)in the validation group.Time-dependent ROC areas under the curve were 0.802(95％CI:0.722-0.850)and 0.718(95％CI:0.640-0.808)for the modeling and validation groups,respectively.Calibration curves for both groups indicated a good model fit,and decision curve analysis demonstrated a positive net benefit,highlighting the clinical applicability of the model.Conclusions The modified five-item frailty index,ICU admission,preoperative hemoglobin,surgical waiting time,and age independently predict one-year mortality after surgery for intertrochanteric fractures in elderly patients.This prognostic model,utilizing these factors,shows high predictive accuracy,assisting clinicians in quick personalized assessments and setting informed expectations in clinical practice.
Fracture fixationInternalFemoral fracturesMortalityPrognostic model
万方数据
维普
