Development and validation of a novel nomogram of 1-year mortality in the elderly with hip fracture: a study of the MIMIC-III database

作者：Qian Chen, Hao Peng, Chipiu Wong, Xiaoxin Zhong, Qing He, Yantao Chen · 发表于：BMJ Open · 年份：2023 · DOI：10.1136/bmjopen-2022-068465 · 被引用次数：12 · 研究领域：Hip and Femur Fractures、Statistical Methods in Epidemiology、Management of metastatic bone disease

OBJECTIVE: Hip fracture is a prevalent condition with a significant death rate among the elderly. We sought to develop a nomogram-based survival prediction model for older patients with hip fracture. DESIGN: A retrospective case-control study. SETTING: The data from Medical Information Mart for Intensive Care III (MIMIC-III V.1.4). PARTICIPANTS: The clinical features of elderly patients with hip fracture, including basic information, comorbidities, severity score, laboratory tests and therapy, were filtered out based on the MIMIC-III V.1.4. METHODS AND MAIN OUTCOME MEASURES: All patients included in the study were from critical care and randomly divided into training and validation sets (7:3). On the basis of retrieved data, the least absolute shrinkage and selection operator (LASSO) regression and multiple logistic regression analysis were used to identify independent predictive variables of 1-year mortality, and then constructed a risk prediction nomogram. The predictive values of the nomogram model were evaluated by the concordance indexes (C-indexes), receiver operating characteristic curve, decision curve analysis (DCA) and calibration curve. RESULTS: A total of 341 elderly patients with hip fracture were included in this study; 121 cases died within 1 year. After LASSO regression and multiple logistic regression analysis, a novel nomogram contained the predictive variables of age, weight, the proportion of lymphocyte count, liver disease, malignant tumour and congestive...