A nomogram for predicting mortality risk in geriatric patients with hip fractures complicated by pneumonia: A multicenter study.

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL
SAGE Open Medicine Pub Date : 2025-02-06 eCollection Date: 2025-01-01 DOI:10.1177/20503121251319168
Kaiming Zhang, Xiangwei Li, Yujia Xiao, Cheng Zhou, Yu Liu, Fan Zhen, Hao Zhang, Mao Nie
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Abstract

Objectives: Pneumonia is a common perioperative complication in geriatric patients with hip fractures. This study aimed to analyze demographic characteristics, mortality rates, postoperative outcomes, and perioperative comorbidities, identify risk factors for mortality, and develop a nomogram for predicting the prognosis of these patients.

Methods: Data on patients hospitalized for arthroplasty for hip fractures from 2020 to 2023 at three hospitals were retrospectively analyzed. Patients were divided into the P group (patients with hip fractures complicated with pneumonia) and the C group (patients with hip fractures without pneumonia) and demographic characteristics, mortality, postoperative outcomes, and perioperative comorbidities of the patients were analyzed. Multiple logistic regression was then used to identify independent risk factors for inpatient mortality in the P group and a nomogram was constructed to predict inpatient mortality. The predictive performance of the nomogram was assessed using receiver operating characteristic curves, decision curve analysis, and calibration curves.

Results: A total of 311 patients participated in the study. Patients in the P group had longer hospitalization (p = 0.001), higher inpatient mortality (p < 0.001), higher mortality (30 days) (p < 0.001), and a poorer recovery of hip function (p < 0.001). Multiple logistic regression showed that age, BMI, total hip arthroplasty, diabetes, and chronic obstructive pulmonary disease were independent risk factors for inpatient mortality in the P group; these factors were incorporated in the nomogram. The C-index of the nomogram was 0.868 (95% CI: 0.802-0.933), and the C-index of internal bootstrapping validation was 0.851 (95% CI: 0.793-0.908), indicating the effectiveness of the nomogram in predicting patient prognosis.

Conclusions: Coinfection with pneumonia adversely affected both recovery of hip function and survival in geriatric patients with hip fractures. Age, BMI, total hip arthroplasty, diabetes, and chronic obstructive pulmonary disease were found to be independent risk factors for mortality in this patient population.

预测老年髋部骨折合并肺炎患者死亡风险的nomogram:一项多中心研究
目的:肺炎是老年髋部骨折患者围手术期常见的并发症。本研究旨在分析人口统计学特征、死亡率、术后结局和围手术期合并症,确定死亡率的危险因素,并制定预测这些患者预后的nomogram。方法:回顾性分析三家医院2020 - 2023年髋部骨折髋关节置换术住院患者的资料。将患者分为P组(髋部骨折合并肺炎患者)和C组(髋部骨折未合并肺炎患者),分析患者的人口学特征、死亡率、术后结局及围手术期合并症。然后使用多元逻辑回归来确定P组住院死亡率的独立危险因素,并构建nomogram来预测住院死亡率。使用受试者工作特征曲线、决策曲线分析和校准曲线评估nomogram预测性能。结果:共311例患者参与研究。P组患者住院时间较长(P = 0.001),住院死亡率较高(P < 0.001),死亡率(30天)较高(P < 0.001),髋关节功能恢复较差(P < 0.001)。多元logistic回归分析显示,年龄、BMI、全髋关节置换术、糖尿病和慢性阻塞性肺疾病是P组住院患者死亡的独立危险因素;这些因素被纳入到图中。nomogram C-index为0.868 (95% CI: 0.802 ~ 0.933), internal bootstrapping validation的C-index为0.851 (95% CI: 0.793 ~ 0.908),说明nomogram预测患者预后的有效性。结论:老年髋部骨折患者合并肺炎对髋功能恢复和生存均有不利影响。年龄、身体质量指数、全髋关节置换术、糖尿病和慢性阻塞性肺疾病是该患者死亡率的独立危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
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