Materiały źródłowe

• #1 Osteoporotic hip fracture prediction from risk factors available in administrative claims data – A machine learning approach | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232969

  Hip fractures are among the most frequently occurring fragility fractures in older adults, associated with a loss of quality of life, high mortality, and high use of healthcare resources. […] The aim of the study was to develop and validate a prediction algorithm for osteoporotic hip fracture based on claims data employing a superlearner approach. […] The performance of the superlearner was similar to other individual algorithms used in the analysis. […] The lack of substantive difference between these methods does not speak against the superlearner per se. […] In our case, however, any of the methods we included, and in particular simpler ones, may be used for these data to predict fracture risk.

• #2 Hip fracture – Wikipedia

  https://en.wikipedia.org/wiki/Hip_fracture

  Prognosis ~20% one year risk of death (older people)[3][1] […] Hip fractures are very dangerous episodes, especially for elderly and frail patients. The risk of dying from the stress of the surgery and the injury in the first thirty days is about 7%.[53] At one year after fracture, this may reach 30%.[54] If the condition is untreated the pain and immobility imposed on the patient increase that risk. Problems such as pressure sores and chest infections are all increased by immobility. The prognosis of untreated hip fractures is very poor.[citation needed] […] Among those affected over the age of 65, 40% are transferred directly to long-term care facilities, long-term rehabilitation facilities, or nursing homes; most of those affected require some sort of living assistance from family or home-care providers. 50% permanently require walkers, canes, or crutches for mobility; all require some sort of mobility assistance throughout the healing process. Most of the recovery of walking ability and activities of daily living occurs within 6 months of the fracture.[56] After the fracture about half of older people recover their pre-fracture level of mobility and ability to perform instrumental activities of daily living, while 40-70% regain their level of independence for basic activities of daily living.[56]

• #3 Time to surgery is critical for survival after hip fracture | Australian Commission on Safety and Quality in Health Care

  https://www.safetyandquality.gov.au/newsroom/latest-news/time-surgery-critical-survival-after-hip-fracture

  Many people with a hip fracture wait longer than is optimal for surgery – despite some hospitals making a dramatic improvement in time to surgery in the past few years. […] Hip fracture significantly increases an older person’s risk of death, with one in four people dying within 12 months after a hip fracture injury. […] The updated Hip Fracture Clinical Care Standard (2023) for hospitals has reduced the maximum time to surgery from 48 hours to 36 hours in line with international guidelines. […] The data is sobering, as an Australian with a hip fracture is almost four times more likely to die within a year than someone of the same age who isn’t injured. […] Shorter time to surgery is associated with fewer complications, better recovery and survival. […] The sooner you operate, the quicker patients can get walking and go home.

• #4 Predicting 30-day mortality after hip fracture surgery | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/2046-3758.69.BJR-2017-0020.R1

  The National Hip Fracture Database (NHFD) publishes hospital-level risk-adjusted mortality rates following hip fracture surgery in England, Wales and Northern Ireland. […] The 30-day mortality rate was 5.36% in the validation dataset (n = 3861), slightly lower than the 6.40% in the development dataset (n = 4044). […] Both models have limitations in predicting mortality for individual patients after hip fracture surgery, but the NHFD risk adjustment model performed as well as the widely-used Nottingham prognostic tool and is therefore a reasonable alternative for risk adjustment in the United Kingdom hip fracture population. […] The model used by the National Hip Fracture Database performed as well as the Nottingham Hip Fracture Score. […] The National Hip Fracture Database model is a suitable alternative to the Nottingham Hip Fracture Score for risk adjustment in the United Kingdom hip fracture population.

• #5

  https://journals.lww.com/jbjsjournal/fulltext/2025/03050/multidimensional_approach_for_predicting_30_day.4.aspx

  The aim of this study was to develop an accurate and clinically relevant prediction model for 30-day mortality following hip fracture surgery. […] A total of 3,523 patients were analyzed, of whom 302 (8.6%) died within 30 days after surgery. […] The Rotterdam Hip Fracture Mortality Prediction-30 Days (RHMP-30) was developed and externally validated, and showed adequate performance in predicting 30-day mortality following hip fracture surgery. […] Estimating the risk of 30-day mortality following hip surgery is important in the decision-making process regarding the surgical intervention. […] The observed 30-day mortality rates were 9.6% (training cohort) and 7.0% (testing cohort). […] The following variables were included in the prediction model after performing the LASSO analysis: age, gender, ASA 4, dementia, albumin level, Katz-ADL total score, and residence in a nursing home. […] The calibration plot showed good consistency between observed and predicted mortality rates. […] The RHMP-30 may be a helpful prediction model for shared decision-making with the patient and their family.

• #6 One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-019-55196-6

  Older adult patients with hip fractures are 34 times more likely to die within one-year after surgery than general population. […] The 16.6% of patients died within one-year after surgery. […] At the multivariate analysis, advancing age (OR=1.094, 95% CI=1.0571.132), higher baseline Charlson Index (OR=1.257, 95% CI=1.1141.418) and Activities of Daily Living scores (OR=1.259, 95% CI=1.1431.388), presence of hospital-acquired pressure ulcers (PUs) (OR=1.579, 95% CI=1.0022.489) and lack recovery of ambulation (OR=1.736, 95% CI=1.1152.703), were found to be independent predictive factors of one-year mortality after surgery. […] The area under the ROC curve of the model was 0.780 (CI95% 0.7370.824) for one-year mortality in elderly hip fractures patients. […] The mortality in the first year after hip fractures surgery is high, ranging between 15% and 36%.

• #7 Predictors of one-year mortality following hip fracture surgery in elderly [PeerJ]

  https://peerj.com/articles/16008/

  Understanding mortality risk factors is critical to reducing mortality among elderly hip fracture patients. […] One-year mortality was 34.7%. […] Based on binary logistic regression analysis, presence of chronic obstructive pulmonary disease (COPD), RDW, and albumin values at admission were found to be independent predictors of 1-year mortality in elderly patients with hip fracture. […] Based on this study, presence of COPD, higher RDW, and lower albumin levels at admission were independent predictors of 1-year mortality following hip fracture surgery in the elderly. […] The mortality rate at 1 year was 34.7%. […] The presence of COPD at admission was found a significant independent predictor of 1-year mortality following hip surgery in the elderly. […] This study reveals that at admission higher RDW, lower albumin levels, and presence of COPD were found as independent predictors of 1-year mortality following hip fracture surgery in the elderly.

• #8 Development of Prediction Model for 1-year Mortality after Hip Fracture Surgery

  https://www.hipandpelvis.or.kr/journal/view.html?volume=36&number=2&spage=135

  The mortality prediction model that was developed in this study calculates the risk of death at one year for patients with hip fractures, is simple, and could detect high risk patients that need special management. […] Mortality for the whole cohort was 19.4% at one year. […] The area under the curve for the prediction model was 0.814. […] The primary objective of this study is to determine risk factors for mortality at 12 months after surgery for treatment of a hip fracture and to develop a prognostic model for use in preoperative decision making. […] Age, sex, comorbidities, ASA, time to surgery, BMI, and use of anti-coagulants can affect the probability of death. […] The predicted probability of death for a mortality score of 8, 9, and 10 is 17%-20%, 26%-28%, and 29%-31%, respectively.

• #9 Hip fracture – Wikipedia

  https://en.wikipedia.org/wiki/Hip_fracture

  Prognosis ~20% one year risk of death (older people)[3][1] […] Hip fractures are very dangerous episodes, especially for elderly and frail patients. The risk of dying from the stress of the surgery and the injury in the first thirty days is about 7%.[53] At one year after fracture, this may reach 30%.[54] If the condition is untreated the pain and immobility imposed on the patient increase that risk. Problems such as pressure sores and chest infections are all increased by immobility. The prognosis of untreated hip fractures is very poor.[citation needed] […] Among those affected over the age of 65, 40% are transferred directly to long-term care facilities, long-term rehabilitation facilities, or nursing homes; most of those affected require some sort of living assistance from family or home-care providers. 50% permanently require walkers, canes, or crutches for mobility; all require some sort of mobility assistance throughout the healing process. Most of the recovery of walking ability and activities of daily living occurs within 6 months of the fracture.[56] After the fracture about half of older people recover their pre-fracture level of mobility and ability to perform instrumental activities of daily living, while 40-70% regain their level of independence for basic activities of daily living.[56]

• #10 One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-019-55196-6

  Dubljanin-Raspopovic et al. showed that the mortality rates a year after hip fracture was 34 times higher than expected in the general population. […] Advanced age, male sex, clinical comorbidities, place of residence before fracture, cognitive impairment and time-to-surgery have been suggested as significant predictors of postoperative mortality in hip fracture patients. […] The multivariate analysis allowed us to identify a total of five independent predictive factors. Being older (OR=1.094, 95% CI=1.0571.132), having a higher baseline Charlson Index (OR=1.257, 95% CI=1.1141.418) and ADL (OR=1.259, 95% CI=1.1431.388) score, presenting hospital-acquired PUs (OR=1.579, 95% CI=1.0022.489) and experiencing lack recovery of ambulation (OR=1.736, 95% CI=1.1152.703), were found to be statistically significant predictive factors of one year mortality after surgery.

• #11 One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-019-55196-6

  Dubljanin-Raspopovic et al. showed that the mortality rates a year after hip fracture was 34 times higher than expected in the general population. […] Advanced age, male sex, clinical comorbidities, place of residence before fracture, cognitive impairment and time-to-surgery have been suggested as significant predictors of postoperative mortality in hip fracture patients. […] The multivariate analysis allowed us to identify a total of five independent predictive factors. Being older (OR=1.094, 95% CI=1.0571.132), having a higher baseline Charlson Index (OR=1.257, 95% CI=1.1141.418) and ADL (OR=1.259, 95% CI=1.1431.388) score, presenting hospital-acquired PUs (OR=1.579, 95% CI=1.0022.489) and experiencing lack recovery of ambulation (OR=1.736, 95% CI=1.1152.703), were found to be statistically significant predictive factors of one year mortality after surgery.

• #12 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #13 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #14 Acute and chronic kidney disease in elderly patients with hip fracture: prevalence, risk factors and outcome with development and validation of a risk prediction model for acute kidney injury | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-017-0437-5

  Acute kidney injury following hip fracture is common and associated with worse outcome and greater hospital length of stay. […] Mortality as an inpatient, 30-days and one year was increased for those patients who developed AKI and those with pre-existing chronic kidney disease. […] Multivariate analysis identified age (continuous and categorised), male sex, pre-existing CKD=3B and AMTS 7 as independent risk factors for 30-day mortality. […] CKD and AKI are common findings in elderly hip fracture patients. Both are independently associated with poor outcome mortality, critical care use and length of acute hospital stay.

• #15 One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-019-55196-6

  Dubljanin-Raspopovic et al. showed that the mortality rates a year after hip fracture was 34 times higher than expected in the general population. […] Advanced age, male sex, clinical comorbidities, place of residence before fracture, cognitive impairment and time-to-surgery have been suggested as significant predictors of postoperative mortality in hip fracture patients. […] The multivariate analysis allowed us to identify a total of five independent predictive factors. Being older (OR=1.094, 95% CI=1.0571.132), having a higher baseline Charlson Index (OR=1.257, 95% CI=1.1141.418) and ADL (OR=1.259, 95% CI=1.1431.388) score, presenting hospital-acquired PUs (OR=1.579, 95% CI=1.0022.489) and experiencing lack recovery of ambulation (OR=1.736, 95% CI=1.1152.703), were found to be statistically significant predictive factors of one year mortality after surgery.

• #16 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #17 Development of Prediction Model for 1-year Mortality after Hip Fracture Surgery

  https://www.hipandpelvis.or.kr/journal/view.html?volume=36&number=2&spage=135

  The mortality prediction model that was developed in this study calculates the risk of death at one year for patients with hip fractures, is simple, and could detect high risk patients that need special management. […] Mortality for the whole cohort was 19.4% at one year. […] The area under the curve for the prediction model was 0.814. […] The primary objective of this study is to determine risk factors for mortality at 12 months after surgery for treatment of a hip fracture and to develop a prognostic model for use in preoperative decision making. […] Age, sex, comorbidities, ASA, time to surgery, BMI, and use of anti-coagulants can affect the probability of death. […] The predicted probability of death for a mortality score of 8, 9, and 10 is 17%-20%, 26%-28%, and 29%-31%, respectively.

• #18 How Do Older Adults Fare After Hip Fracture? > Health in Aging Blog > Health in Aging

  https://www.healthinaging.org/blog/how-do-older-adults-fare-after-hip-fracture/

  Hip fractures in older adults can be extremely serious, and often result in chronic illness, death, and increased health care costs. Experts estimate that some 18 to 33 percent of all older adults who have suffered hip fractures will die within a year, with even higher rates of death among people who have dementia or who live in a nursing home. […] As many as 50 percent of older adults face difficulties following a hip fracture, and may be unable to bathe, feed, or dress themselves (called activities of daily living, or ADLs). […] Studies conducted on older adults who have had hip fractures suggest that the strongest indication that a person will experience a decline after a hip fracture is being disabled before the fracture occurs. […] The researchers said that their study showed that having cognitive impairment, including dementia and in-hospital delirium, can be a major predictor of functional problems and disability following hip fracture, even for older adults who were able to function well before having a hip fracture. […] The researchers said that their work showed that older adults who were independent before their hip fractures, but who had cognitive impairment or experienced in-hospital delirium, experienced poorer outcomes after their hip surgery.

• #19 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #20 One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-019-55196-6

  Dubljanin-Raspopovic et al. showed that the mortality rates a year after hip fracture was 34 times higher than expected in the general population. […] Advanced age, male sex, clinical comorbidities, place of residence before fracture, cognitive impairment and time-to-surgery have been suggested as significant predictors of postoperative mortality in hip fracture patients. […] The multivariate analysis allowed us to identify a total of five independent predictive factors. Being older (OR=1.094, 95% CI=1.0571.132), having a higher baseline Charlson Index (OR=1.257, 95% CI=1.1141.418) and ADL (OR=1.259, 95% CI=1.1431.388) score, presenting hospital-acquired PUs (OR=1.579, 95% CI=1.0022.489) and experiencing lack recovery of ambulation (OR=1.736, 95% CI=1.1152.703), were found to be statistically significant predictive factors of one year mortality after surgery.

• #21 Predictors of one-year mortality following hip fracture surgery in elderly [PeerJ]

  https://peerj.com/articles/16008/

  Understanding mortality risk factors is critical to reducing mortality among elderly hip fracture patients. […] One-year mortality was 34.7%. […] Based on binary logistic regression analysis, presence of chronic obstructive pulmonary disease (COPD), RDW, and albumin values at admission were found to be independent predictors of 1-year mortality in elderly patients with hip fracture. […] Based on this study, presence of COPD, higher RDW, and lower albumin levels at admission were independent predictors of 1-year mortality following hip fracture surgery in the elderly. […] The mortality rate at 1 year was 34.7%. […] The presence of COPD at admission was found a significant independent predictor of 1-year mortality following hip surgery in the elderly. […] This study reveals that at admission higher RDW, lower albumin levels, and presence of COPD were found as independent predictors of 1-year mortality following hip fracture surgery in the elderly.

• #22 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #23 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #24 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #25 Acute and chronic kidney disease in elderly patients with hip fracture: prevalence, risk factors and outcome with development and validation of a risk prediction model for acute kidney injury | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-017-0437-5

  Hip fracture is a common injury in older people with a high rate of postoperative morbidity and mortality. This patient group is also at high risk of acute kidney injury (AKI) and chronic kidney disease (CKD), but little is known of the impact of kidney disease on outcome following hip fracture. […] Acute kidney injury occurs in 24%; development of acute kidney injury is independently associated with male sex (OR 1.48 (1.21 to 1.80), premorbid chronic kidney disease stage 3B or worse (OR 1.52 (1.19 to 1.93)), age (OR 3.4 (2.29 to 5.2) for 85 years) and greater than one major co-morbidities (OR 1.61 (1.34 to 1.93)). Acute kidney injury of any stage is associated with an increased hazard of death, and increased length of stay (Acute kidney injury: 19.1 (IQR 13 to 31) days; no acute kidney injury 15 (11 to 23) days).

• #26 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #27 Time to surgery is critical for survival after hip fracture | Australian Commission on Safety and Quality in Health Care

  https://www.safetyandquality.gov.au/newsroom/latest-news/time-surgery-critical-survival-after-hip-fracture

  Many people with a hip fracture wait longer than is optimal for surgery – despite some hospitals making a dramatic improvement in time to surgery in the past few years. […] Hip fracture significantly increases an older person’s risk of death, with one in four people dying within 12 months after a hip fracture injury. […] The updated Hip Fracture Clinical Care Standard (2023) for hospitals has reduced the maximum time to surgery from 48 hours to 36 hours in line with international guidelines. […] The data is sobering, as an Australian with a hip fracture is almost four times more likely to die within a year than someone of the same age who isn’t injured. […] Shorter time to surgery is associated with fewer complications, better recovery and survival. […] The sooner you operate, the quicker patients can get walking and go home.

• #28 Development of Prediction Model for 1-year Mortality after Hip Fracture Surgery

  https://www.hipandpelvis.or.kr/journal/view.html?volume=36&number=2&spage=135

  The mortality prediction model that was developed in this study calculates the risk of death at one year for patients with hip fractures, is simple, and could detect high risk patients that need special management. […] Mortality for the whole cohort was 19.4% at one year. […] The area under the curve for the prediction model was 0.814. […] The primary objective of this study is to determine risk factors for mortality at 12 months after surgery for treatment of a hip fracture and to develop a prognostic model for use in preoperative decision making. […] Age, sex, comorbidities, ASA, time to surgery, BMI, and use of anti-coagulants can affect the probability of death. […] The predicted probability of death for a mortality score of 8, 9, and 10 is 17%-20%, 26%-28%, and 29%-31%, respectively.

• #29

  https://link.springer.com/article/10.1007/s11657-022-01150-5

  A total of 32.5% of the patients died within 1 year after surgery, with a significant difference between those who resided in rural areas (43.1%) and those who resided in urban areas (23.5%) (RR 1.70; 95% CI, 1.03 to 2.80, p=0.036). […] In the multivariate analysis, anemia (hemoglobin level 9.0 g/dL during hospitalization) (RR 6.61; 95% CI, 1.49-29.37, p=0.003), a blood transfusion requirement (RR 1.47; 95% CI, 1.07 to 2.01, p=0.015), the type of fracture (subtrochanteric fracture (RR=4.9, 95% CI=1.41-16.943, p=0.005)), and postoperative acute decompensation of chronic disease (RR 1.60; 95% CI, 1.01 to 2.53, p=0.043) were found to be independent predictive factors of 1-year mortality after surgery. […] There was a difference in 1-year mortality between patients from rural and urban areas. More studies must be conducted to determine whether rurality behaves as an independent risk factor or is related to other variables, such as the burden of comorbidities and in-hospital complications.

• #30 Postoperative hypotension following acute hip fracture surgery is a predictor of 30-day mortality | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/0301-620X.106B2.BJJ-2023-0692.R2

  Postoperative hypotension following acute hip fracture surgery is a predictor of 30-day mortality. […] Our study is the first to demonstrate that postoperative hypotension within the first 24 hours is an independent risk factor for 30-day mortality after hip fracture surgery. […] Immediate postoperative hypotension within 24 hours is a significant independent risk factor associated with 30-day mortality. […] The outcome of our multivariate analysis demonstrates that postoperative hypotension, in our study defined as the lowest SBP 90 mmHg within two to 24 hours of leaving theatre, is an independent risk factor when accounting for other known variables. […] Our results are the first to demonstrate that immediate postoperative hypotension is a strong risk factor when predicting 30-day mortality in hip fracture patients.

• #31 One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-019-55196-6

  Dubljanin-Raspopovic et al. showed that the mortality rates a year after hip fracture was 34 times higher than expected in the general population. […] Advanced age, male sex, clinical comorbidities, place of residence before fracture, cognitive impairment and time-to-surgery have been suggested as significant predictors of postoperative mortality in hip fracture patients. […] The multivariate analysis allowed us to identify a total of five independent predictive factors. Being older (OR=1.094, 95% CI=1.0571.132), having a higher baseline Charlson Index (OR=1.257, 95% CI=1.1141.418) and ADL (OR=1.259, 95% CI=1.1431.388) score, presenting hospital-acquired PUs (OR=1.579, 95% CI=1.0022.489) and experiencing lack recovery of ambulation (OR=1.736, 95% CI=1.1152.703), were found to be statistically significant predictive factors of one year mortality after surgery.

• #32 One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-019-55196-6

  Dubljanin-Raspopovic et al. showed that the mortality rates a year after hip fracture was 34 times higher than expected in the general population. […] Advanced age, male sex, clinical comorbidities, place of residence before fracture, cognitive impairment and time-to-surgery have been suggested as significant predictors of postoperative mortality in hip fracture patients. […] The multivariate analysis allowed us to identify a total of five independent predictive factors. Being older (OR=1.094, 95% CI=1.0571.132), having a higher baseline Charlson Index (OR=1.257, 95% CI=1.1141.418) and ADL (OR=1.259, 95% CI=1.1431.388) score, presenting hospital-acquired PUs (OR=1.579, 95% CI=1.0022.489) and experiencing lack recovery of ambulation (OR=1.736, 95% CI=1.1152.703), were found to be statistically significant predictive factors of one year mortality after surgery.

• #33

  https://link.springer.com/article/10.1007/s11657-022-01150-5

  A total of 32.5% of the patients died within 1 year after surgery, with a significant difference between those who resided in rural areas (43.1%) and those who resided in urban areas (23.5%) (RR 1.70; 95% CI, 1.03 to 2.80, p=0.036). […] In the multivariate analysis, anemia (hemoglobin level 9.0 g/dL during hospitalization) (RR 6.61; 95% CI, 1.49-29.37, p=0.003), a blood transfusion requirement (RR 1.47; 95% CI, 1.07 to 2.01, p=0.015), the type of fracture (subtrochanteric fracture (RR=4.9, 95% CI=1.41-16.943, p=0.005)), and postoperative acute decompensation of chronic disease (RR 1.60; 95% CI, 1.01 to 2.53, p=0.043) were found to be independent predictive factors of 1-year mortality after surgery. […] There was a difference in 1-year mortality between patients from rural and urban areas. More studies must be conducted to determine whether rurality behaves as an independent risk factor or is related to other variables, such as the burden of comorbidities and in-hospital complications.

• #34 Length of hospital stay after hip fracture and risk of early mortality after discharge in New York state: retrospective cohort study | The BMJ

  https://www.bmj.com/content/351/bmj.h6246

  Hospital stays of 11-14 days for hip fracture were associated with a 32% increased odds of death 30 days after discharge, compared with stays lasting one to five days (odds ratio 1.32 (95% confidence interval 1.19 to 1.47)). […] These odds increased to 103% for stays longer than 14 days (2.03 (1.84 to 2.24)). […] The 30 day mortality rate after discharge was 4.5% for surgically treated patients and 10.7% for non-surgically treated patients. […] A shorter hospital stay (5 days and 10 days) was also associated with decreased 30 day mortality. […] On multivariate regression analysis, discharge to a hospice facility and age older than 90 years were the largest risk factors for 30 day mortality. A hospital stay longer than 10 days, compared with a stay of five days or fewer, was associated with increased odds of mortality during the first 30 days after discharge.

• #35 Rapid preoperative predicting tools for 1-year mortality and walking ability of Asian elderly femoral neck fracture patients who planned for hip arthroplasty | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02605-0

  Our results showed that serum ALB was predictive for both 1-year mortality and mobility, which was consistent with other studies. […] Preoperative walking ability showed the biggest impact on predicting 1-year mortality and walking ability. […] Our models might be more applicable for Asian elderly hip fracture patients. […] The predictive efficiency of those models in Asian populations has not yet been evaluated. […] Our study was subjected to some limitations.

• #36 Predictors of one-year mortality following hip fracture surgery in elderly [PeerJ]

  https://peerj.com/articles/16008/

  Understanding mortality risk factors is critical to reducing mortality among elderly hip fracture patients. […] One-year mortality was 34.7%. […] Based on binary logistic regression analysis, presence of chronic obstructive pulmonary disease (COPD), RDW, and albumin values at admission were found to be independent predictors of 1-year mortality in elderly patients with hip fracture. […] Based on this study, presence of COPD, higher RDW, and lower albumin levels at admission were independent predictors of 1-year mortality following hip fracture surgery in the elderly. […] The mortality rate at 1 year was 34.7%. […] The presence of COPD at admission was found a significant independent predictor of 1-year mortality following hip surgery in the elderly. […] This study reveals that at admission higher RDW, lower albumin levels, and presence of COPD were found as independent predictors of 1-year mortality following hip fracture surgery in the elderly.

• #37 Predictors of one-year mortality following hip fracture surgery in elderly [PeerJ]

  https://peerj.com/articles/16008/

  Understanding mortality risk factors is critical to reducing mortality among elderly hip fracture patients. […] One-year mortality was 34.7%. […] Based on binary logistic regression analysis, presence of chronic obstructive pulmonary disease (COPD), RDW, and albumin values at admission were found to be independent predictors of 1-year mortality in elderly patients with hip fracture. […] Based on this study, presence of COPD, higher RDW, and lower albumin levels at admission were independent predictors of 1-year mortality following hip fracture surgery in the elderly. […] The mortality rate at 1 year was 34.7%. […] The presence of COPD at admission was found a significant independent predictor of 1-year mortality following hip surgery in the elderly. […] This study reveals that at admission higher RDW, lower albumin levels, and presence of COPD were found as independent predictors of 1-year mortality following hip fracture surgery in the elderly.

• #38 Can nutritional and inflammatory indices predict 90-day mortality in fragility hip fracture patients? | SICOT-J

  https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230059/sicotj230059.html

  Hip fractures in the elderly are related to increased mortality. The identification of patients at risk is essential. Several nutritional and inflammatory parameters were investigated in an effort to find a prognostic indicator for mortality following fragility hip fractures (FHF) surgery. […] The PLR was found to be correlated with mortality risk following FHF surgery. As it can be easily calculated from accessible blood tests, we recommend its routine assessment as a screening tool for personalized management of patients at high risk for mortality. […] Fragility hip fractures are associated with increased morbidity and mortality rates of up to 20-30% in the post-operative year. […] While many indices aim to detect patients at risk for reduced survival, we found only the platelets to lymphocytes ratio to correlate with 90 days postoperative mortality.

• #39 Mortality Prediction in Hip Fracture Patients: Physician Assessment Versus Prognostic Models

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9555757/

  To evaluate 2 prognostic models for mortality after a fracture of the hip, the Nottingham Hip Fracture Score and Hip Fracture Estimator of Mortality Amsterdam and to compare their predictive performance to physician assessment of mortality risk in hip fracture patients. […] Mortality was 7.4% after 30 days, 22.1% after 1 year, and 59.4% after 5 years. […] In this study, prognostic models and physicians demonstrated similar discriminating abilities when predicting mortality in hip fracture patients. Although physicians overestimated mortality, they were better at identifying high-risk patients and at predicting long-term mortality. […] Although some risk models show good predictive performance, their usefulness in clinical practice remains to be determined. […] The NHFS had near perfect calibration in the large for 30-day mortality, but the calibration slope demonstrated underfitting (overestimation of low risks and underestimation of high risks).

• #40 Mortality Prediction in Hip Fracture Patients: Physician Assessment Versus Prognostic Models

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9555757/

  To evaluate 2 prognostic models for mortality after a fracture of the hip, the Nottingham Hip Fracture Score and Hip Fracture Estimator of Mortality Amsterdam and to compare their predictive performance to physician assessment of mortality risk in hip fracture patients. […] Mortality was 7.4% after 30 days, 22.1% after 1 year, and 59.4% after 5 years. […] In this study, prognostic models and physicians demonstrated similar discriminating abilities when predicting mortality in hip fracture patients. Although physicians overestimated mortality, they were better at identifying high-risk patients and at predicting long-term mortality. […] Although some risk models show good predictive performance, their usefulness in clinical practice remains to be determined. […] The NHFS had near perfect calibration in the large for 30-day mortality, but the calibration slope demonstrated underfitting (overestimation of low risks and underestimation of high risks).

• #41 Mortality Prediction in Hip Fracture Patients: Physician Assessment Versus Prognostic Models

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9555757/

  The HEMA demonstrated considerable systematic overestimation of 30-day mortality and substantial overfitting. […] Physician assessment overestimated 30-day mortality but less so than the HEMA. […] Mortality prediction in hip fracture patients is complicated, and the perfect prognostic model does not exist. […] In this study, prediction models could not outperform physicians when assessing mortality risk and did not improve on baseline clinical judgment.

• #42 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #43 Predicting 1-Year Mortality after Hip Fracture Surgery: An Evaluation of Multiple Machine Learning Approaches

  https://www.mdpi.com/2075-4426/11/8/727?type=check_update&version=2

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] The logistic regression (LR) method of prediction is well-known to researchers and surgeons, and our recent work demonstrated that convolutional neural networks do not outperform LR in predicting 30-day postoperative mortality in hip fracture patients. […] The LR model including all the variables demonstrated an acceptable predictive ability on both the training and test datasets for predicting one-year postoperative mortality (Area under the curve (AUC) = 0.74 and 0.74 respectively). […] The most important predictors of 1-year mortality were the presence of a metastatic carcinoma, American Society of Anesthesiologists(ASA) classification, sex, Charlson Comorbidity Index (CCI) ≤ 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

• #44

  https://journals.lww.com/international-journal-of-surgery/fulltext/2025/01000/predicting_all_cause_mortality_and_postoperative.158.aspx

  Radiomics score of hip muscles was identified as an independent risk factor of all-cause mortality after geriatric hip fracture surgery. […] A novel radio-clinical model was developed and externally validated specifically for all-cause mortality following hip fracture surgery. […] This combined model showed great discrimination and calibration. […] The added value of the radiomics signature in postoperative pneumonia prediction was determined. […] However, the high risk of death after surgery within 1-year (mortality rate, 25-30%) was unaccepted. […] Radiomics score [HR, 0.67 (95% CI: 0.45-0.81)] was identified as an independent risk factor of mortality (P<0.05). [...] The combined model for predicting 1-year mortality had a great performance, with AUCs of 0.90 (95% CI: 0.87-0.93).

• #45

  https://journals.lww.com/international-journal-of-surgery/fulltext/2025/01000/predicting_all_cause_mortality_and_postoperative.158.aspx

  Radiomics score of hip muscles was identified as an independent risk factor of all-cause mortality after geriatric hip fracture surgery. […] A novel radio-clinical model was developed and externally validated specifically for all-cause mortality following hip fracture surgery. […] This combined model showed great discrimination and calibration. […] The added value of the radiomics signature in postoperative pneumonia prediction was determined. […] However, the high risk of death after surgery within 1-year (mortality rate, 25-30%) was unaccepted. […] Radiomics score [HR, 0.67 (95% CI: 0.45-0.81)] was identified as an independent risk factor of mortality (P<0.05). [...] The combined model for predicting 1-year mortality had a great performance, with AUCs of 0.90 (95% CI: 0.87-0.93).

• #46 Hip fracture – Wikipedia

  https://en.wikipedia.org/wiki/Hip_fracture

  Prognosis ~20% one year risk of death (older people)[3][1] […] Hip fractures are very dangerous episodes, especially for elderly and frail patients. The risk of dying from the stress of the surgery and the injury in the first thirty days is about 7%.[53] At one year after fracture, this may reach 30%.[54] If the condition is untreated the pain and immobility imposed on the patient increase that risk. Problems such as pressure sores and chest infections are all increased by immobility. The prognosis of untreated hip fractures is very poor.[citation needed] […] Among those affected over the age of 65, 40% are transferred directly to long-term care facilities, long-term rehabilitation facilities, or nursing homes; most of those affected require some sort of living assistance from family or home-care providers. 50% permanently require walkers, canes, or crutches for mobility; all require some sort of mobility assistance throughout the healing process. Most of the recovery of walking ability and activities of daily living occurs within 6 months of the fracture.[56] After the fracture about half of older people recover their pre-fracture level of mobility and ability to perform instrumental activities of daily living, while 40-70% regain their level of independence for basic activities of daily living.[56]

• #47 Hip fracture – Wikipedia

  https://en.wikipedia.org/wiki/Hip_fracture

  Prognosis ~20% one year risk of death (older people)[3][1] […] Hip fractures are very dangerous episodes, especially for elderly and frail patients. The risk of dying from the stress of the surgery and the injury in the first thirty days is about 7%.[53] At one year after fracture, this may reach 30%.[54] If the condition is untreated the pain and immobility imposed on the patient increase that risk. Problems such as pressure sores and chest infections are all increased by immobility. The prognosis of untreated hip fractures is very poor.[citation needed] […] Among those affected over the age of 65, 40% are transferred directly to long-term care facilities, long-term rehabilitation facilities, or nursing homes; most of those affected require some sort of living assistance from family or home-care providers. 50% permanently require walkers, canes, or crutches for mobility; all require some sort of mobility assistance throughout the healing process. Most of the recovery of walking ability and activities of daily living occurs within 6 months of the fracture.[56] After the fracture about half of older people recover their pre-fracture level of mobility and ability to perform instrumental activities of daily living, while 40-70% regain their level of independence for basic activities of daily living.[56]

• #48 Rapid preoperative predicting tools for 1-year mortality and walking ability of Asian elderly femoral neck fracture patients who planned for hip arthroplasty | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02605-0

  Femoral neck fractures in elderly patients typically warrant operative treatment and are related to high risks of mortality and morbidity. […] The final analysis was performed on 702 patients after exclusion and follow-up. All-cause 1-year mortality of the entire data set was 23.4%, while the free walking rate was 57.3%. […] Our models enabled rapid preoperative 1-year mortality and walking ability predictions in Asian elderly femoral neck fracture patients who planned for hip arthroplasty, with adequate predictive discrimination and calibration. […] The C-index in binary outcomes predicting models represents the ability to distinguish between patients who experience an event from those who do not. […] Our results showed that the free walking rate 1 year after arthroplasty was 57.3%.

• #49 Rapid preoperative predicting tools for 1-year mortality and walking ability of Asian elderly femoral neck fracture patients who planned for hip arthroplasty | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02605-0

  Our results showed that serum ALB was predictive for both 1-year mortality and mobility, which was consistent with other studies. […] Preoperative walking ability showed the biggest impact on predicting 1-year mortality and walking ability. […] Our models might be more applicable for Asian elderly hip fracture patients. […] The predictive efficiency of those models in Asian populations has not yet been evaluated. […] Our study was subjected to some limitations.

• #50 How Do Older Adults Fare After Hip Fracture? > Health in Aging Blog > Health in Aging

  https://www.healthinaging.org/blog/how-do-older-adults-fare-after-hip-fracture/

  Hip fractures in older adults can be extremely serious, and often result in chronic illness, death, and increased health care costs. Experts estimate that some 18 to 33 percent of all older adults who have suffered hip fractures will die within a year, with even higher rates of death among people who have dementia or who live in a nursing home. […] As many as 50 percent of older adults face difficulties following a hip fracture, and may be unable to bathe, feed, or dress themselves (called activities of daily living, or ADLs). […] Studies conducted on older adults who have had hip fractures suggest that the strongest indication that a person will experience a decline after a hip fracture is being disabled before the fracture occurs. […] The researchers said that their study showed that having cognitive impairment, including dementia and in-hospital delirium, can be a major predictor of functional problems and disability following hip fracture, even for older adults who were able to function well before having a hip fracture. […] The researchers said that their work showed that older adults who were independent before their hip fractures, but who had cognitive impairment or experienced in-hospital delirium, experienced poorer outcomes after their hip surgery.

• #51 How Do Older Adults Fare After Hip Fracture? > Health in Aging Blog > Health in Aging

  https://www.healthinaging.org/blog/how-do-older-adults-fare-after-hip-fracture/

  Hip fractures in older adults can be extremely serious, and often result in chronic illness, death, and increased health care costs. Experts estimate that some 18 to 33 percent of all older adults who have suffered hip fractures will die within a year, with even higher rates of death among people who have dementia or who live in a nursing home. […] As many as 50 percent of older adults face difficulties following a hip fracture, and may be unable to bathe, feed, or dress themselves (called activities of daily living, or ADLs). […] Studies conducted on older adults who have had hip fractures suggest that the strongest indication that a person will experience a decline after a hip fracture is being disabled before the fracture occurs. […] The researchers said that their study showed that having cognitive impairment, including dementia and in-hospital delirium, can be a major predictor of functional problems and disability following hip fracture, even for older adults who were able to function well before having a hip fracture. […] The researchers said that their work showed that older adults who were independent before their hip fractures, but who had cognitive impairment or experienced in-hospital delirium, experienced poorer outcomes after their hip surgery.

• #52 How Do Older Adults Fare After Hip Fracture? > Health in Aging Blog > Health in Aging

  https://www.healthinaging.org/blog/how-do-older-adults-fare-after-hip-fracture/

  Hip fractures in older adults can be extremely serious, and often result in chronic illness, death, and increased health care costs. Experts estimate that some 18 to 33 percent of all older adults who have suffered hip fractures will die within a year, with even higher rates of death among people who have dementia or who live in a nursing home. […] As many as 50 percent of older adults face difficulties following a hip fracture, and may be unable to bathe, feed, or dress themselves (called activities of daily living, or ADLs). […] Studies conducted on older adults who have had hip fractures suggest that the strongest indication that a person will experience a decline after a hip fracture is being disabled before the fracture occurs. […] The researchers said that their study showed that having cognitive impairment, including dementia and in-hospital delirium, can be a major predictor of functional problems and disability following hip fracture, even for older adults who were able to function well before having a hip fracture. […] The researchers said that their work showed that older adults who were independent before their hip fractures, but who had cognitive impairment or experienced in-hospital delirium, experienced poorer outcomes after their hip surgery.

• #53 Time to surgery is critical for survival after hip fracture | Australian Commission on Safety and Quality in Health Care

  https://www.safetyandquality.gov.au/newsroom/latest-news/time-surgery-critical-survival-after-hip-fracture

  The evidence tells us the sooner you are supported to get out of bed, the better your functional recovery. […] Older people can have complex needs, and research shows the best results come when specialists from both orthopaedic surgery and geriatric medicine work together on a patient’s care – known as an orthogeriatric model of care. […] The standard has already been a catalyst for change. By updating it and addressing the gaps, care will continue to improve.

• #54 Time to surgery is critical for survival after hip fracture | Australian Commission on Safety and Quality in Health Care

  https://www.safetyandquality.gov.au/newsroom/latest-news/time-surgery-critical-survival-after-hip-fracture

  Many people with a hip fracture wait longer than is optimal for surgery – despite some hospitals making a dramatic improvement in time to surgery in the past few years. […] Hip fracture significantly increases an older person’s risk of death, with one in four people dying within 12 months after a hip fracture injury. […] The updated Hip Fracture Clinical Care Standard (2023) for hospitals has reduced the maximum time to surgery from 48 hours to 36 hours in line with international guidelines. […] The data is sobering, as an Australian with a hip fracture is almost four times more likely to die within a year than someone of the same age who isn’t injured. […] Shorter time to surgery is associated with fewer complications, better recovery and survival. […] The sooner you operate, the quicker patients can get walking and go home.

• #55 Time to surgery is critical for survival after hip fracture | Australian Commission on Safety and Quality in Health Care

  https://www.safetyandquality.gov.au/newsroom/latest-news/time-surgery-critical-survival-after-hip-fracture

  Many people with a hip fracture wait longer than is optimal for surgery – despite some hospitals making a dramatic improvement in time to surgery in the past few years. […] Hip fracture significantly increases an older person’s risk of death, with one in four people dying within 12 months after a hip fracture injury. […] The updated Hip Fracture Clinical Care Standard (2023) for hospitals has reduced the maximum time to surgery from 48 hours to 36 hours in line with international guidelines. […] The data is sobering, as an Australian with a hip fracture is almost four times more likely to die within a year than someone of the same age who isn’t injured. […] Shorter time to surgery is associated with fewer complications, better recovery and survival. […] The sooner you operate, the quicker patients can get walking and go home.

• #56 Time to surgery is critical for survival after hip fracture | Australian Commission on Safety and Quality in Health Care

  https://www.safetyandquality.gov.au/newsroom/latest-news/time-surgery-critical-survival-after-hip-fracture

  The evidence tells us the sooner you are supported to get out of bed, the better your functional recovery. […] Older people can have complex needs, and research shows the best results come when specialists from both orthopaedic surgery and geriatric medicine work together on a patient’s care – known as an orthogeriatric model of care. […] The standard has already been a catalyst for change. By updating it and addressing the gaps, care will continue to improve.

• #57 Time to surgery is critical for survival after hip fracture | Australian Commission on Safety and Quality in Health Care

  https://www.safetyandquality.gov.au/newsroom/latest-news/time-surgery-critical-survival-after-hip-fracture

  The evidence tells us the sooner you are supported to get out of bed, the better your functional recovery. […] Older people can have complex needs, and research shows the best results come when specialists from both orthopaedic surgery and geriatric medicine work together on a patient’s care – known as an orthogeriatric model of care. […] The standard has already been a catalyst for change. By updating it and addressing the gaps, care will continue to improve.

• #58 Postoperative hypotension following acute hip fracture surgery is a predictor of 30-day mortality | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/0301-620X.106B2.BJJ-2023-0692.R2

  Postoperative hypotension following acute hip fracture surgery is a predictor of 30-day mortality. […] Our study is the first to demonstrate that postoperative hypotension within the first 24 hours is an independent risk factor for 30-day mortality after hip fracture surgery. […] Immediate postoperative hypotension within 24 hours is a significant independent risk factor associated with 30-day mortality. […] The outcome of our multivariate analysis demonstrates that postoperative hypotension, in our study defined as the lowest SBP 90 mmHg within two to 24 hours of leaving theatre, is an independent risk factor when accounting for other known variables. […] Our results are the first to demonstrate that immediate postoperative hypotension is a strong risk factor when predicting 30-day mortality in hip fracture patients.

• #59

  https://link.springer.com/article/10.1007/s11657-022-01150-5

  A total of 32.5% of the patients died within 1 year after surgery, with a significant difference between those who resided in rural areas (43.1%) and those who resided in urban areas (23.5%) (RR 1.70; 95% CI, 1.03 to 2.80, p=0.036). […] In the multivariate analysis, anemia (hemoglobin level 9.0 g/dL during hospitalization) (RR 6.61; 95% CI, 1.49-29.37, p=0.003), a blood transfusion requirement (RR 1.47; 95% CI, 1.07 to 2.01, p=0.015), the type of fracture (subtrochanteric fracture (RR=4.9, 95% CI=1.41-16.943, p=0.005)), and postoperative acute decompensation of chronic disease (RR 1.60; 95% CI, 1.01 to 2.53, p=0.043) were found to be independent predictive factors of 1-year mortality after surgery. […] There was a difference in 1-year mortality between patients from rural and urban areas. More studies must be conducted to determine whether rurality behaves as an independent risk factor or is related to other variables, such as the burden of comorbidities and in-hospital complications.

• #60 Can nutritional and inflammatory indices predict 90-day mortality in fragility hip fracture patients? | SICOT-J

  https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230059/sicotj230059.html

  Hip fractures in the elderly are related to increased mortality. The identification of patients at risk is essential. Several nutritional and inflammatory parameters were investigated in an effort to find a prognostic indicator for mortality following fragility hip fractures (FHF) surgery. […] The PLR was found to be correlated with mortality risk following FHF surgery. As it can be easily calculated from accessible blood tests, we recommend its routine assessment as a screening tool for personalized management of patients at high risk for mortality. […] Fragility hip fractures are associated with increased morbidity and mortality rates of up to 20-30% in the post-operative year. […] While many indices aim to detect patients at risk for reduced survival, we found only the platelets to lymphocytes ratio to correlate with 90 days postoperative mortality.

• #61 Can nutritional and inflammatory indices predict 90-day mortality in fragility hip fracture patients? | SICOT-J

  https://www.sicot-j.org/articles/sicotj/full_html/2023/01/sicotj230059/sicotj230059.html

  In conclusion, of the several nutritional and inflammatory indices hypothesized to predict mortality following fragility hip fractures, only the PLR indicator was found to correlate with 90 days mortality. Its calculation is straightforward, as it is based on blood exams which are routinely obtained on admission and may provide important information on patients who are at high risk for mortality.

• #62 Development of Prediction Model for 1-year Mortality after Hip Fracture Surgery

  https://www.hipandpelvis.or.kr/journal/view.html?volume=36&number=2&spage=135

  The mortality prediction model that was developed in this study calculates the risk of death at one year for patients with hip fractures, is simple, and could detect high risk patients that need special management. […] Mortality for the whole cohort was 19.4% at one year. […] The area under the curve for the prediction model was 0.814. […] The primary objective of this study is to determine risk factors for mortality at 12 months after surgery for treatment of a hip fracture and to develop a prognostic model for use in preoperative decision making. […] Age, sex, comorbidities, ASA, time to surgery, BMI, and use of anti-coagulants can affect the probability of death. […] The predicted probability of death for a mortality score of 8, 9, and 10 is 17%-20%, 26%-28%, and 29%-31%, respectively.

• #63 Development of Prediction Model for 1-year Mortality after Hip Fracture Surgery

  https://www.hipandpelvis.or.kr/journal/view.html?volume=36&number=2&spage=135

  The mortality prediction model that was developed in this study calculates the risk of death at one year for patients with hip fractures, is simple, and could detect high risk patients that need special management. […] Mortality for the whole cohort was 19.4% at one year. […] The area under the curve for the prediction model was 0.814. […] The primary objective of this study is to determine risk factors for mortality at 12 months after surgery for treatment of a hip fracture and to develop a prognostic model for use in preoperative decision making. […] Age, sex, comorbidities, ASA, time to surgery, BMI, and use of anti-coagulants can affect the probability of death. […] The predicted probability of death for a mortality score of 8, 9, and 10 is 17%-20%, 26%-28%, and 29%-31%, respectively.

• #64 Hip fracture – Wikipedia

  https://en.wikipedia.org/wiki/Hip_fracture

  Among those affected over the age of 50, approximately 25% die within the next year due to complications such as blood clots (deep venous thrombosis, pulmonary embolism), infections, and pneumonia.[citation needed] […] Patients with hip fractures are at high risk for future fractures including hip, wrist, shoulder, and spine. After treatment of the acute fracture, the risk of future fractures should be addressed. Currently, only 1 in 4 patients after a hip fracture receives treatment and work up for osteoporosis, the underlying cause of most of the fractures. Current treatment standards include the starting of a bisphosphonate to reduce future fracture risk by up to 50%.[citation needed]

• #65 Hip fracture – Wikipedia

  https://en.wikipedia.org/wiki/Hip_fracture

  Among those affected over the age of 50, approximately 25% die within the next year due to complications such as blood clots (deep venous thrombosis, pulmonary embolism), infections, and pneumonia.[citation needed] […] Patients with hip fractures are at high risk for future fractures including hip, wrist, shoulder, and spine. After treatment of the acute fracture, the risk of future fractures should be addressed. Currently, only 1 in 4 patients after a hip fracture receives treatment and work up for osteoporosis, the underlying cause of most of the fractures. Current treatment standards include the starting of a bisphosphonate to reduce future fracture risk by up to 50%.[citation needed]

• #66 A plasma protein-based risk score to predict hip fractures | Nature Aging

  https://www.nature.com/articles/s43587-024-00639-7

  The developed proteomic risk score improved hip fracture prediction and discrimination in three independent validation cohorts, analyzed by two substantially different proteomic platforms. […] Finally, when added to FRAX with or without information on eBMD, the proteomic risk score, but not available PRSs, improved hip fracture discrimination. […] The proteomic risk score significantly improved the hip fracture discrimination and reclassification indexes beyond a base model, including both FRAX without and with addition of eBMD. […] The proteomic risk score predicted hip fractures similarly in both young and old participants, and in both men and women.

• #67 A plasma protein-based risk score to predict hip fractures | Nature Aging

  https://www.nature.com/articles/s43587-024-00639-7

  The developed proteomic risk score improved hip fracture prediction and discrimination in three independent validation cohorts, analyzed by two substantially different proteomic platforms. […] Finally, when added to FRAX with or without information on eBMD, the proteomic risk score, but not available PRSs, improved hip fracture discrimination. […] The proteomic risk score significantly improved the hip fracture discrimination and reclassification indexes beyond a base model, including both FRAX without and with addition of eBMD. […] The proteomic risk score predicted hip fractures similarly in both young and old participants, and in both men and women.

• #68 Days alive and at home after hip fracture: a cross-sectional validation of a patient-centred outcome measure using routinely collected data | BMJ Quality & Safety

  https://qualitysafety.bmj.com/content/32/9/546

  Days alive and at home (DAH) is a patient centered outcome measureable in routinely collected health data. The validity and minimally important difference (MID) in hip fracture have not been evaluated. […] We assessed construct and predictive validity and estimated a MID for the patient-centred outcome of DAH after hip fracture admission. […] DAH has face, construct and predictive validity as a patient-centred outcome in patients with hip fracture, with an estimated MID of 11 days. […] In this population-based cross-sectional analysis of linked health administrative data, we found that the number of days alive and at home after hip fracture admission had construct and predictive validity as a patient-centred outcome that can be captured from routinely collected electronic data sources. We further estimated that a difference of 11 days may represent an MID in DAH90 for patients with hip fracture, although this value may vary in certain clinically relevant subgroups and should be further evaluated with direct patient engagement.

• #69 One-year mortality after hip fracture surgery and prognostic factors: a prospective cohort study | Scientific Reports

  https://www.nature.com/articles/s41598-019-55196-6

  Dubljanin-Raspopovic et al. showed that the mortality rates a year after hip fracture was 34 times higher than expected in the general population. […] Advanced age, male sex, clinical comorbidities, place of residence before fracture, cognitive impairment and time-to-surgery have been suggested as significant predictors of postoperative mortality in hip fracture patients. […] The multivariate analysis allowed us to identify a total of five independent predictive factors. Being older (OR=1.094, 95% CI=1.0571.132), having a higher baseline Charlson Index (OR=1.257, 95% CI=1.1141.418) and ADL (OR=1.259, 95% CI=1.1431.388) score, presenting hospital-acquired PUs (OR=1.579, 95% CI=1.0022.489) and experiencing lack recovery of ambulation (OR=1.736, 95% CI=1.1152.703), were found to be statistically significant predictive factors of one year mortality after surgery.

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