Key result
A 9-predictor prognostic model using preoperative characteristics accurately predicted 1-year survival after fragile hip fracture with a c-statistic of 0.814.
Why the study?
No prognostic model for fragile hip fracture survival had been developed for Asians.
Cohort (n=735)
No
Effect estimate: c-statistic 0.814 (95% CI 0.762-0.865)
A newly developed prognostic model using 9 preoperative predictors accurately predicts 1-year survival in Asian patients with fragile hip fractures, aiding in personalized treatment planning.
May support preoperative risk stratification in Asian hip fracture patients; leaves open external validation before clinical adoption.
BackgroundNo prognostic model for the survival of fragile hip fracture has been developed for Asians. The goal of this study was to develop a simple and practical prognostic model to predict survival within 1 year after fragile hip fracture in Asians.MethodsA single-center retrospective cohort study was designed. Under a multivariable Cox proportional hazards regression model, we used the preoperative characteristics of patients to predict survival within 1 year after hip fracture. We built a full model and then used the least absolute shrinkage and selection operator (LASSO) method to further shrink the model coefficients and achieved variable screening. Finally, we obtained a LASSO model. The model performance was evaluated with Nagelkerke’s R2 and the concordance (c) statistic. We assessed the internal validity with a bootstrapping procedure of 1 000 repetitions.ResultsA total of 735 eligible patients were admitted to our department for hip fracture from January 2015 to December 2020, but 11 (1.5%) patients were lost to follow-up. Among the remaining patients, 68 (9.3%) died within 1 year after hip fracture. We identified 12 candidate predictors from the preoperative characteristics of the patients. The last model contained 9 predictors: surgery, age, albumin, sex, serum creatinine, malignancy, hypertension, ability to live independently, and cardiovascular and cerebrovascular diseases. Among them, surgery, age and albumin are effective predictors of survival. The discrimination c statistic of the model is 0.814 (95% confidence interval 0.762–0.865); the corrected value through internal validation is 0.795.ConclusionsThis prognostic model can accurately predict a 1-year survival rate for patients with fragile hip fractures. This information can help clinicians develop a reasonable and personalized treatment plan.
No takes yet. Share an insight, caveat, or question.
Fu et al. (2021) conducted a cohort in Fragile hip fracture (n=735). 9-predictor LASSO prognostic model was evaluated on 1-year survival prediction (discrimination) (c-statistic 0.814, 95% CI 0.762-0.865). A 9-predictor prognostic model using preoperative characteristics accurately predicted 1-year survival after fragile hip fracture with a c-statistic of 0.814.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: