A formula for predicting postoperative functional decline using routine medical data in elderly patients after hip fracture surgery

IF 0.2 Q4 ORTHOPEDICS
Taeko Fukuda, S. Imai, K. Maruo, H. Horiguchi
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引用次数: 0

Abstract

Background: If functional decline after hip surgery can be predicted without special assessment, the effects of new treatments and rehabilitation practices can be easily compared with previous cases or those in other countries. The purpose of this study was to develop and examine a formula for such prediction. Methods: Data of 3,120 patients older than 65 yr with hip fracture were analyzed. The Barthel Index was used for evaluating activities of daily living (ADL). Low ADL was defined as patients with a lower score at discharge than the score at admission and patients with complete dependence at admission that did not change until discharge. Three models were developed in a training sample: Basic, Comorbidity, and Laboratory & Vital Signs models were created by inputting basic patient data, the basic data plus comorbidities, the basic data and comorbidities plus 8 laboratory test results and 5 vital signs, respectively. All potential variables with statistical significance < 0.2 on univariate analyses and some variables that may be clinically meaningful were included in multivariable models. The final model was developed by stepwise logistic regression. Results: The c-statistic of the Laboratory & Vital Signs formula was 0.701 and the predictive value was 76.9%. The c-statistics of the Basic and Comorbidity formulas were 0.643 and 0.664, respectively. Applying the Laboratory & Vital Signs formula to the validation sample, the c-statistic was 0.663. Conclusions: The formula developed from the medical data collected routinely before surgery could predict low ADL following hip fracture surgery in elderly patients. Level of Evidence: IVb
应用常规医疗数据预测老年髋部骨折术后功能衰退的公式
背景:如果髋关节手术后的功能下降可以在没有特殊评估的情况下预测,那么新的治疗和康复实践的效果可以很容易地与以前或其他国家的病例进行比较。本研究的目的是开发和检验这种预测的公式。方法:对3120例65岁以上髋部骨折患者的临床资料进行分析。Barthel指数用于评估日常生活活动(ADL)。低ADL被定义为出院时得分低于入院时得分的患者,以及入院时完全依赖直到出院才改变的患者。在训练样本中开发了三个模型:基本、合并症和实验室和生命体征模型分别通过输入患者基本数据、基本数据加合并症、基本数据和合并症加8个实验室检测结果和5个生命体征创建。单变量分析中统计显著性<0.2的所有潜在变量和一些可能具有临床意义的变量均包含在多变量模型中。通过逐步逻辑回归建立最终模型。结果:实验室和生命体征公式的c统计量为0.701,预测值为76.9%。基础和合并症公式的c统计学分别为0.643和0.664。将实验室和生命体征公式应用于验证样本,c统计量为0.663。结论:根据手术前常规收集的医学数据开发的公式可以预测老年患者髋部骨折手术后ADL低。证据级别:IVb
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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
107
期刊介绍: Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Current Orthopaedic Practice is a peer-reviewed, general orthopaedic journal that translates clinical research into best practices for diagnosing, treating, and managing musculoskeletal disorders. The journal publishes original articles in the form of clinical research, invited special focus reviews and general reviews, as well as original articles on innovations in practice, case reports, point/counterpoint, and diagnostic imaging.
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