Development of a Prognostic Model for 1-year Survival of Fragile Hip Fracture in Chinese
Abstract Background: No prognostic model for survival of fragile hip fracture has been developed for Asians. The goal of this study is to develop a simple and practical prognosis model to predict the survival within 1 year after fragile hip fracture of Asians.Methods: A single Center and retrospective cohort study was designed. Under a multivariable Cox Proportional Hazards Regression Model, we used the preoperative characteristics of patients to predict survival within 1 year after hip fracture. We built a full model, then used the “least absolute shrinkage and selection operator(LASSO)” method to further shrink the model coefficients and achieved variable screening. Finally, we got a LASSO model. The model performance was evaluated with the Nagelkerke’s R2 and the concordance (c) statistic. We assessed internal validity with a bootstrapping procedure of 1 000 repetitions.RESULTS: 735 eligible patients were admitted to our department for hip fracture from January 2015 to December 2020. 11(1.5%) patients lost follow-up. Among the rest, 68(9.3%) died within 1 year after hip fracture. We finally identified 12 candidate predictors from preoperative characteristics of patients. The last model contains 9 predictors; that are surgery, age, albumin, sex, serum creatinine, malignancy, hypertension, the ability of living independence, and cardiovascular and cerebrovascular diseases. Among them, surgery, age and albumin are the effective predictors of survival. The discrimination c statistic of the model is 0.814 (95% confidence interval 0.762-0.865); the corrected value through internal validation is 0.795. CONCLUSIONS: This prognostic model can provide a 1-year survival rate for patients with fragile hip fractures. This information can help clinicians develop a reasonable and personalized treatment plan.