高龄髋部骨折患者术后新发衰弱预测模型的构建

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Abstract Objective To construct a prediction model for new-onset frailty in aged patients with hip fracture and provide a basis to protect aged patients from postoperative new-onset frailty.Methods The elderly patients with hip fracture who were admitted to the Seventh Medical Center of Chinese PLA General Hospital from August 1, 2020 to October 1, 2021 and underwent surgical treatment were included. FRAIL Screening Scale (FRAIL Scale) was used to evaluate those who suffer from frailty within three months after surgery, so that patients could be divided into frailty group and non-frailty group. Patients' basic information, preoperative nottingham hip fracture score (NHFS), surgical options, anesthetic methods, laboratory examination and other data were collected, Kendall correlation analysis was used to explore the correlation between preoperative NHFS and postoperative frailty, Logistic regression was used to analyze the interfering factors of postoperative frailty and construct the prediction model, and receiver operating characteristic curve (ROC curve) was used to evaluate the predictive efficiency of the model.Results A total of 192 patients were enrolled, including 49 patients in the frailty group and 143 patients in the non-frailty group. The NHFS of frailty group was significantly higher than that of non-frailty group (P<0.001) and NHFS was positively correlated with frailty (P<0.001). Logistic regression model analysis showd NHFS (OR=2.425, 95%CI 1.438-4.090, P=0.001), prognostic nutritional index (PNI) at admission [serum albumin (g/L) +5×lymphocyte count (10⁹/L)] (OR=0.861, 95%CI 0.767-0.966, P=0.011), fracture type (OR=5.692, 95%CI 1.511-21.438, P=0.010), and the highest creatinine during hospitalization (OR=1.151, 95%CI 1.047-1.265, P=0.004) were independent risk factors for postoperative new-onset frailty. The area under curve (AUC) predicted by the above four independent risk factors was 0.797 (P<0.001).The predictive efficiency of the model was ideal and its fitting degree was excellent (P=0.915).Conclusions The prediction model based on NHFS, PNI, fracture type and the highest Cr value during hospitalization has a good predictive efficiency for postoperative new-onset frailty in aged patients with hip fracture, which can provide a basis for early intervention of postoperative new-onset frailty.

Key words： hip fracture the aged postoperative frailty nottingham hip fracture score

Received: 08 October 2022

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	Articles by authors
	LIU Qinghua
	SUN Mingyue
	ZHANG Chen
	NI Juanjuan
	MAO Xiaoqing
	ZHAO Dan
	GAO Minglong
	FENG Long

Cite this article:

LIU Qinghua,SUN Mingyue,ZHANG Chen等. Construction of a prediction model for postoperative new-onset frailty in aged patients with hip fracture[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(2): 144-149.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2023/V34/I2/144

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