Materiały źródłowe

• #1 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. […] 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).

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

  https://www.mdpi.com/2075-4426/11/8/727

  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.

• #3 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%.

• #4 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.

• #5 Multivariable prediction models for long-term… | HRB Open Research

  https://hrbopenresearch.org/articles/5-44

  Hip fracture results in high mortality and, for many survivors, long-term functional limitations. […] The aim of this study is to identify, critically appraise and synthesise published multivariable prediction models for long-term outcomes after hip fracture. […] Accurate prediction could aid clinical decision making and prognosis discussions with family members in the context of gaining informed consent for procedures and practices. […] Assessing functional prognosis could also help to identify patients that require further supports in the long-term to enable them to continue to live as independently as possible. […] The aim of this systematic review is to identify, critically appraise and synthesise published multivariable prediction models for long-term outcomes occurring after hospital discharge or at least 30 days after hip fracture.

• #6 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. […] Numerous models, both generic and hip fracture-specific, have been developed to predict mortality after hip fracture surgery. […] The model used by the National Hip Fracture Database performed as well as the Nottingham Hip Fracture Score.

• #7 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.

• #8 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 model is a suitable alternative to the Nottingham Hip Fracture Score for risk adjustment in the United Kingdom hip fracture population. […] The NHFD and Nottingham models showed a slightly lower discrimination in the validation dataset compared with the development dataset, but both still displayed moderate discriminative power (c-statistic for NHFD = 0.71, 95% confidence interval (CI) 0.67 to 0.74; Nottingham model = 0.70, 95% CI 0.68 to 0.75). […] Both models defined similar ranges of predicted mortality risk (1% to 18%) in assessment of calibration.

• #9

  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. […] 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.

• #10

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

  The predicted mortality had a good fit within all of the CIs for observed mortality. […] The RHMP-30 may be a helpful prediction model for shared decision-making with the patient and their family. […] The prediction model is based on 2 very detailed databases and very extensive statistical analyses. This may make the RHMP-30 the most reliable prediction model for 30-day mortality for patients with a hip fracture to date.

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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8401745/

  Postoperative death within 1 year following hip fracture surgery is reported to be up to 27%. […] 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. […] The LR model itself demonstrated an acceptable predictive ability, with an AUC of 0.74 in the test dataset using all variables and the top ten most important predictive variables.

• #12 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

  In this prospective cohort study of 728 patients who underwent surgical treatment for hip fractures, we found the predictive factors for one-year mortality included older age, a higher number of comorbidities, a higher pre-fracture dependence in ADLs, the presence of hospital acquired pressure ulcers and lack of recovery ambulation.

• #13 Predictors of poor functional outcomes and mortality in patients with hip fracture: a systematic review | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-2950-0

  Hip fracture is an important and prevalent medical condition associated with adverse outcomes. The aim of this article is to systematically review and summarise the predictors of poor functional outcomes and mortality for patients with hip fractures. […] We identified two emerging predictors of poor functional outcomes and mortality for patients with hip fractures: low hand grip strength and frailty in line with an emerging concept of physical performance. The predictors identified in this systematic review can be grouped into 1) medical factors, such as presence of co-morbidities, high American Society of Anesthesiologists (ASA) grade, sarcopenia, 2) surgical factors including delay in operation (e.g. 48h), type of fracture, 3) socio-economic factors which include age, gender, ethnicity, and 4) system factors including lower case-volume centers.

• #14 Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality | Trauma Surgery & Acute Care Open

  https://tsaco.bmj.com/content/7/1/e000962

  In the adjusted Poisson regression analysis, frailty (defined as an OFS 2) was associated with a 244% increased risk of 30-day postoperative mortality. […] The OFS could accordingly be a useful and simple tool for incorporating frailty into research and clinical decision-making among patients with hip fracture. […] The OFS is a significant predictor of short-term postoperative mortality in patients with hip fracture that outperforms, or performs on par with, all other investigated indices.

• #15 Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality | Trauma Surgery & Acute Care Open

  https://tsaco.bmj.com/content/7/1/e000962

  Frailty is common among patients with hip fracture and may, in part, contribute to the increased risk of mortality and morbidity after hip fracture surgery. […] The most important variables for predicting 30-day mortality were congestive heart failure, institutionalization, non-independent functional status, an age 85, and a history of malignancy. […] The OFS is a significant predictor of short-term postoperative mortality in patients with hip fracture that outperforms, or performs on par with, all other investigated indices. […] Hip fractures are associated with a high incidence of postoperative mortality with rates as high as 10%, 16% and 27% being reported after 30, 90 and 365 days, respectively. […] The OFS achieved an AUC (95% CI) of 0.77 (0.74 to 0.80) when predicting 30-day postoperative mortality.

• #16 Can the Clinical Frailty Scale on admission predict 30-day survival, postoperative complications, and institutionalization in patients with fragility hip fracture? | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/0301-620X.104B8.BJJ-2020-1835.R2

  Our study broadly demonstrates a linear relationship between CFS 1 to 4 (patients who are not frail) and surgical outcomes. […] Our results show that frail patients have a poorer outcome than those who are not frail, but in using the CFS we are unable to distinguish differences in outcome for higher frailty levels. […] The CFS predicted 30-day survival with similar accuracy to the NHFS. […] There may be a physiological threshold beyond which the effect on outcomes does not further change. […] The findings of this study would therefore indicate that the CFS does quantify frailty accurately and hence permit prediction of the likelihood of returning to baseline function (as measured by return to independent living). […] We need to ensure that the role of the orthogeriatrician remains at the centre of care for these patients, especially in the early stages of patient assessment and to guide care planning. […] We also need to investigate why there is no difference in outcomes between mildly, moderately, and severely frail patients with respect to mortality, postoperative complications, and LOS.

• #17 Can the Clinical Frailty Scale on admission predict 30-day survival, postoperative complications, and institutionalization in patients with fragility hip fracture? | Bone & Joint

  https://boneandjoint.org.uk/Article/10.1302/0301-620X.104B8.BJJ-2020-1835.R2

  We assessed the value of the Clinical Frailty Scale (CFS) in the prediction of adverse outcome after hip fracture. […] Significant non-linear associations between CFS and outcomes were observed. Risk of death within 30 days rose linearly for CFS 1 to 5, but plateaued for CFS 5. […] Use of the CFS may provide useful information on outcomes for fitter patients presenting with hip fracture, but completion of the CFS by the admitting orthopaedic team does not appear successful in distinguishing between higher CFS categories, which define patients with frailty. […] The routine use of the Clinical Frailty Scale provides useful indications of information on outcomes for fitter patients presenting with hip fracture. […] However, at higher grades of frailty, further work is needed to understand why patients assessed as being of mild, moderate, and severe frailty do not appear to result in different outcomes.

• #18 Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune–Inflammatory–Metabolic Markers and Related Conceptual Issues

  https://www.mdpi.com/2077-0383/13/13/3969

  Among 27 IIM biomarkers, 10 indices were significantly associated with development of PMI and 16 were indicative of a fatal outcome; in the subset of patients aged >80 years with ischaemic heart disease (IHD, the highest risk group: 90.2% of all deaths), the corresponding figures were 26 and 20. […] The highest predictors of in-hospital death were platelet/lymphocyte ratio > 280.0 (AUC 0.8390), lymphocyte/monocyte ratio < 1.1 (AUC 0.8375), albumin < 33 g/L (AUC 0.7889), red cell distribution width > 14.5% (AUC 0.7739), and anaemia (AUC 0.7604), sensitivity 88.2% and above, and specificity 85.1–79.3%. […] Comparison of 27 IIM indices in HF patients identified several simple, widely available, and inexpensive parameters highly predictive for PMI and/or in-hospital death. […] These findings are in line with previous studies and confirm the utility of advanced age, history of IHD, and developing PMI for elucidating the prognosis and identifying the highest risk groups.

• #19 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.

• #20 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 our cohort, PLR was associated with increased 90 mortality. […] PEM is associated with an increased morbidity and mortality. […] In our cohort, it was associated with increased 90 mortality in patients who survived the initial hospitalization. […] 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.

• #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) (OR 3.73, 95% CI [1.87.76]), RDW (OR 1.78, 95% CI [1.482.14]), and albumin (OR 0.81, 95% CI [0.750.87]), 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. […] In this retrospective study, at admission, COPD presence, RDW, and albumin were strongly and independently associated with 1-year mortality in 275 elderly patients with hip fractures treated surgically in a tertiary hospital. […] 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

  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 level9.0 g/dL during hospitalization) (RR 6.61; 95% CI, 1.4929.37, 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=1.41816.943, 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.

• #23

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

  The higher mortality risk of the rural population compared with that of the urban population and the higher incidence of deaths during the first months after surgery revealed by our study are consistent with the results of other authors. […] Our study showed that rural patients had an increased rate of anemia on admission compared with their urban counterparts, and Hb levels decreased after surgical intervention, with a postoperative level9.0 g/dL being another risk factor for mortality 1 year later. […] The current study showed that medical complications during the postoperative period were associated with mortality 1 year later; these complications included COPD exacerbation, acute decompensation of heart failure, acute renal failure superimposed with preexisting chronic kidney failure, hyperosmolar state in diabetic patients, and hypertensive emergencies.

• #24 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.

• #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 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.

• #27 Prediction of Mortality and Postoperative Complications using the Hip-Multidimensional Frailty Score in Elderly Patients with Hip Fracture | Scientific Reports

  https://www.nature.com/articles/srep42966

  High mortality and dependent living after hip fracture pose a significant public health concern. […] The primary outcome was the 6-month all-cause mortality rate. […] The fully adjusted hazard ratio per 1 point increase in Hip-MFS was 1.458 (95% confidence interval [CI]: 1.2101.758) for 6-months mortality and odds ratio were 1.239 (95% CI: 1.1151.377), 1.156 (95% CI: 1.0311.296) for postoperative complications and prolonged total hospital stay, respectively. […] High-risk patients (Hip-MFS8) showed higher risk of 6-month mortality (hazard ratio: 3.545, 95% CI: 1.4668.572) than low-risk patients after adjustment. […] Hip-MFS successfully predict 6-month mortality, postoperative complications and prolonged hospital stay in elderly hip fracture patients after surgery. […] The primary endpoint was 6-month all-cause mortality after surgery.

• #28 Prediction of Mortality and Postoperative Complications using the Hip-Multidimensional Frailty Score in Elderly Patients with Hip Fracture | Scientific Reports

  https://www.nature.com/articles/srep42966

  The hazard ratios per 1 point in the model were 1.458 (95% CI: 1.2101.758, P0.001) for 6-month all-cause mortality, 1.419 (95% CI: 1.2391.626, P0.001) for 1-year all-cause mortality after full adjustment. […] Using the criterion of a score above 8, 117 patients (24.3%) were categorized as high-risk group. […] The cumulative 6-month survival rates of the two groups were statistically significant according to the Kaplan-Meier curve (P0.001 by log-rank test). […] The Hip-MFS predicts 6-month all-cause mortality more accurately than the ASA classification, chronological age and NHFS according to the comparison of AUC (Area under curve) area of ROC curve. […] In this study, we verified that the Hip-MFS independently predicted 6-month all-cause mortality, 1-year all-cause mortality, postoperative complications, and prolonged total or postoperative hospital stay in elderly hip fracture patients who underwent surgery.

• #29 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

  Hip fractures are associated with increased mortality. The identification of risk factors of mortality could improve patient care. The aim of the study was to identify risk factors of mortality after surgery for a hip fracture and construct a mortality model. Mortality for the whole cohort was 19.4% at one year. From the variables tested only age 80 years, American Society of Anesthesiologists category, time to surgery (48 hours), Charlson comorbidity index, sex, use of anti-coagulants, and body mass index 2 were associated with increased mortality and used to construct the mortality model. The area under the curve for the prediction model was 0.814. 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. An association of hip fractures in older persons with a lower quality of life for the patient, as well as increased morbidity and mortality has been reported. 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. In-hospital mortality was 2.4%. Mortality for the entire cohort was 19.4% at one year. Among the variables tested, BMI 25 kg/m2, age 80 years, CCI 6, time to surgery 48 hours, ASA 3, use of anti-coagulants, and male sex showed an association with increased mortality. The calculated AUC was 0.814 (95% CI 0.769-0.859, P0.001), which is considered excellent discrimination. The mortality prediction model developed in this study can calculate the risk of death at one year for patients with hip fractures. It is simple to use and could be applied in every day clinical practice for informing patients and caregivers in the process of shared decision making.

• #30 Predictors of poor functional outcomes and mortality in patients with hip fracture: a systematic review | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-2950-0

  This systematic review identified multiple significant predictors of poor functional outcomes and mortality, with the hand grip strength and frailty being important emerging predictors in the most recent literature. These predictors would further inform healthcare providers of their patients health status and allow for early intervention for modifiable predictors. […] One-year mortality rate for patients with hip fracture was reported to be up to 20-24% and the mortality risk may persist beyond 5 years. […] This review summarized and allows readers to have an oversight view of the predictors of poor functional outcomes and mortality for patients with hip fractures. Through identification of these predictors, healthcare providers would be better equipped to identify patients at risk of poor functional outcomes and/or death during their hospital admission.

• #31 Multivariable prediction models for long-term… | HRB Open Research

  https://hrbopenresearch.org/articles/5-44

  The study will aim to identify models that have been derived using high quality methods and will establish their stage of development (derived or validated). […] Most significantly, these models could be useful for national hip fracture audits and registries in reporting risk-adjusted estimates of hospital performance and in accounting for missing data during the assessment of longer-term outcomes.

• #32 Prediction of 30-Day Mortality after a Hip Fracture Surgery Using Neural and Bayesian Networks | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-662-44654-6_56

  Osteoporotic hip fractures have a significant morbidity and excess mortality among the elderly and have imposed huge health and economic burdens on societies worldwide. A medical database of 349 patients that have been operated for hip fracture has been analyzed. Two models of data were used in Multi-Layer Perceptrons, Radial Basis Function and Nave Bayes networks, in order to predict the 30-day mortality after a hip fracture surgery and also to investigate which is the most appropriate risk factor between the New Mobility Score and Institution factor for the Greek population. The proposed method may be used as a screening tool that will assist orthopedics in the surgery of the hip fracture according to each different patient. […] Mortality and morbidity after hip fractures. […] Excess mortality following hip fracture: a systematic epidemiological review.

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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8401745/

  Of the variables analyzed, metastatic carcinoma, ASA classification, sex, CCI 4, age, dementia, congestive heart failure, hypertension, surgery using pins/screws, and chronic kidney disease were the most important for predicting mortality 1 year postoperatively. […] LR outperformed the three other commonly use machine learning algorithms in predicting 1-year postoperative mortality in hip fracture patients.

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