Accuracy of the ACS-NSQIP Risk Calculator, Nottingham Hip Fracture Score and CRP/Albumin Ratio in Predicting Adverse Postoperative Outcomes in the Hip Fracture Surgery: A Lithuanian Single-Centre Prospective Study.

IF 1.6 4区 医学 Q4 GERIATRICS & GERONTOLOGY
Geriatric Orthopaedic Surgery & Rehabilitation Pub Date : 2025-06-25 eCollection Date: 2025-01-01 DOI:10.1177/21514593251352336
Povilas Masionis, Rokas Bobina, Simonas Utkus, Raminta Martinaitytė, Valentinas Uvarovas, Igoris Šatkauskas
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引用次数: 0

Abstract

Objective: As the global population ages, hip fracture importance will increase. The high postoperative mortality and morbidity necessitate tools for accurate risk assessment to aid surgical decisions and inform patients and families. This study aimed to compare and validate ACS NSQIP, Nottingham hip fracture risk calculators, and C reactive protein/albumin ratio in predicting complications and 30 day mortality. Methods: 583 patients over the 65 years old who sustained hip fracture from simple fall and underwent surgical treatment for hip fracture were included in prospective study. Each patient was evaluated by ACS NSQIP and Nottingham hip fracture risk calculators and C reactive protein/albumin ratio was calculated from preoperative values. Patients were followed up for 30 days and all the complications were recorded. Results: ACS NSQIP and Nottingham hip fracture score showed AUC of .724 and .731 respectively. C reactive protein/albumin ratio performed less and showed AUC of .623 that is defined as poor predictor for 30 day mortality. Furthermore, in terms of predicting any complication, ACS NSQIP showed AUC of .645, Nottingham hip fracture score of .611 and C reactive protein/albumin ratio of .594. Nottingham hip fracture score than compared to ACS NSQIP yielded lower average of mortality rates (5.4% compared to 7.9%) in contrast of study findings of 8.1%. None of the ACS NSQIP scale predictive complication showed acceptable performance. When adjusted for fracture type, Nottingham hip fracture score showed .858 AUC in predicting 30 day mortality in femoral neck fractures. Conclusions: We recommend Nottingham fracture risk calculator use for 30 day mortality risk assessment in femoral neck fractures. In hip fractures combined-none of models showed strong discrimination. In our cohort C reactive protein/albumin ratio showed poor prognostic values in terms of mortality and complications.

ACS-NSQIP风险计算器、诺丁汉髋部骨折评分和CRP/白蛋白比值预测髋部骨折术后不良结局的准确性:立陶宛单中心前瞻性研究
目的:随着全球人口老龄化,髋部骨折的重要性将增加。术后高死亡率和发病率需要准确的风险评估工具,以帮助手术决策并告知患者和家属。本研究旨在比较和验证ACS NSQIP、诺丁汉髋部骨折风险计算器和C反应蛋白/白蛋白比在预测并发症和30天死亡率方面的作用。方法:对583例65岁以上单纯跌倒致髋部骨折并行髋部骨折手术治疗的患者进行前瞻性研究。采用ACS NSQIP和Nottingham髋部骨折风险计算器对每位患者进行评估,并根据术前值计算C反应蛋白/白蛋白比值。随访30 d,记录所有并发症。结果:ACS NSQIP评分和Nottingham髋部骨折评分AUC分别为0.724和0.731。C反应蛋白/白蛋白比率表现较差,AUC为0.623,被定义为30天死亡率的不良预测因子。此外,在预测任何并发症方面,ACS NSQIP显示AUC为0.645,Nottingham髋部骨折评分为0.611,C反应蛋白/白蛋白比值为0.594。与ACS NSQIP相比,诺丁汉髋部骨折评分的平均死亡率(5.4%比7.9%)低于研究结果的8.1%。ACS NSQIP量表预测并发症均无可接受的表现。调整骨折类型后,诺丁汉髋部骨折评分预测股骨颈骨折30天死亡率的AUC为0.858。结论:我们推荐使用诺丁汉骨折风险计算器对股骨颈骨折患者进行30天死亡率风险评估。在合并髋部骨折中,没有一个模型显示出强烈的歧视。在我们的队列中,C反应蛋白/白蛋白比率在死亡率和并发症方面显示出较差的预后价值。
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来源期刊
CiteScore
3.00
自引率
0.00%
发文量
80
审稿时长
9 weeks
期刊介绍: Geriatric Orthopaedic Surgery & Rehabilitation (GOS) is an open access, peer-reviewed journal that provides clinical information concerning musculoskeletal conditions affecting the aging population. GOS focuses on care of geriatric orthopaedic patients and their subsequent rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE).
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