Can the APACHE II score be used to assess the risk of mortality in the elderly with hip fractures?

Q2 Medicine

Medicinski Glasnik Pub Date : 2025-01-01 DOI:10.17392/1801-22-01

Tarik Bujaković, Samir Delibegović

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引用次数: 0

Abstract

Aim: Various predictive models have been developed to help identify patients with hip fractures with greater or lower probability of survival. The aim of this study was to establish the capacity of the APACHE II score to predict the survival of patients with hip fracture, in people aged over 65 years, and compare it with the existing score used to predict the survival of these patients.

Methods: This was a prospective, cohort study conducted in a tertiary care teaching hospital including 410 consecutive patients with hip fracture aged ≥65 years. As part of the preoperative preparation, general health of the patients was classified according to the ASA score. The Charlson Comorbidity Index (CCI), the Nottingham Hip Fracture Score (NHFS), the POSSUM-P and the APACHE II scores were analysed.

Results: The sensitivity and specificity of the P-POSSUM score were 78.3 and 73.0, respectively, which was better than the APACHE II whose sensitivity and specificity were 56.6 and 89.7. The area beneath the ROC curve for P-POSSUM was 0.809, and for APACHE II, 0.803. However, there was no statistically significant difference between the APACHE II and P-POSSUM scores. The P-POSSUM and APACHE II scores were statistically significantly better than ASA, the Nottingham score and CCI.

Conclusion: This study showed that POSSUM-P and APACHE II can be used to predict mortality in elderly people with hip fractures.

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APACHE II评分是否可用于评估老年髋部骨折患者的死亡风险？

目的：已经开发了各种预测模型来帮助识别髋部骨折患者的生存概率或高或低。本研究的目的是建立APACHE II评分预测65岁以上髋部骨折患者生存的能力，并将其与用于预测这些患者生存的现有评分进行比较。方法：这是一项在三级护理教学医院进行的前瞻性队列研究，包括410例年龄≥65岁的髋部骨折患者。作为术前准备的一部分，根据ASA评分对患者的总体健康状况进行分类。分析Charlson合并症指数（CCI）、Nottingham髋部骨折评分（NHFS）、POSSUM-P和APACHE II评分。结果：P-POSSUM评分的敏感性和特异性分别为78.3和73.0，优于APACHE II评分的敏感性和特异性分别为56.6和89.7。P-POSSUM的ROC曲线下面积为0.809，APACHE II的ROC曲线下面积为0.803。然而，APACHE II和P-POSSUM评分之间没有统计学上的显著差异。P-POSSUM评分和APACHE II评分均显著优于ASA、Nottingham评分和CCI。结论：POSSUM-P和APACHEⅱ可用于预测老年髋部骨折患者的死亡率。

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

Medicinski Glasnik 医学-医学：内科

CiteScore

2.30

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Medicinski Glasnik (MG) is the official publication (two times per year) of the Medical Association of Zenica-Doboj Canton. Manuscripts that present of original basic and applied research from all fields of medicine (general and clinical practice, and basic medical sciences) are invited.