Factors associated with the occurrence of postoperative infection of intertrochanteric fracture of the femur and its prediction model creation and validation

This study explores the risk factors of postoperative infection of intertrochanteric fracture of the femur to construct and validate the prediction model, so as to provide a basis for clinical early intervention. Clinical data of patients with intertrochanteric fracture of the femur treated in our hospital from January 2020 to December 2024 were retrospectively collected. Independent risk factors were screened by univariate and multivariate logistic regression analyses, and a nomogram was constructed based on the regression model. The predictive efficacy was assessed by calculating the area under the curve using the receiver operating characteristic curve, and the model fit was verified by the Hosmer-Lemeshow goodness-of-fit test. In addition, the Bootstrap method (repeated sampling 1000 times) combined with 10-fold cross-validation was utilized to enhance the stability of the model, while calibration curves were plotted and decision curves were analyzed to assess the predictive accuracy and clinical utility value of the model. Five hundred and sixty-four patients were finally included, of which 36 cases developed postoperative infections (infection rate 6.38%). Results of univariate and multivariate logistic regression analyses showed that intensive care unit admission (odds ratio [ OR[, 6.283; 95% confidence interval [CI], 2.233-17.463), age > 75 years (OR, 2.793; 95% CI, 1.193-6.513), urinary catheter time > 24 h (OR, 3.563; 95% CI, 1.223-8.543), surgery time > 2 h (OR, 3.330; 95% CI, 1.200-7.880), and use of steroids (OR, 3.010; 95% CI, 1.150-7.400) were independent risk factors for postoperative infection. Postoperative infection of intertrochanteric femoral fracture is influenced by multiple factors, and the prediction model constructed in this study showed high predictive accuracy and clinical utility, which can provide strong support for early identification and intervention of patients at high risk of postoperative infection.