Establishment and validation of clinical prediction model and prognosis of perioperative pneumonia in elderly patients with hip fracture complicated with preoperative acute heart failure

作者：Yuying Li, Shuhan Li, Jiaxuan Zhu, Zhiqian Wang, Xiuguo Zhang · 发表于：BMC Surgery · 年份：2024 · DOI：10.1186/s12893-024-02668-w · 被引用次数：4 · 研究领域：Hip and Femur Fractures、Cardiac, Anesthesia and Surgical Outcomes、Hyperglycemia and glycemic control in critically ill and hospitalized patients

BACKGROUND: Elderly hip fracture was a common orthopedic emergency with high perioperative complication risks. Combined with preoperative acute heart failure, the risk increases further, with pneumonia being a common complication. The aim of this study was to construct and evaluate risk factor prediction models for perioperative pneumonia in these patients and to explore prognostic factors. METHODS: A retrospective study design was used to collect data on elderly patients with hip fracture combined with preoperative acute heart failure at the Third Hospital of Hebei Medical University from January 2020 to December 2022. The feature variables were screened by logistic regression and nomogram was constructed. The receiver operating characteristics curve (ROC), decision curve analysis (DCA), and calibration curve were employed to assess the predictive power of the model. Correlation heatmaps and shapley additive explanation (SHAP) were employed to assess key variables and their impact. Employing the Kaplan-Meier curve and Cox regression, the patients' prognosis was ultimately evaluated. RESULTS: 535 elderly patients with hip fracture combined with preoperative acute heart failure were included in this study. Logistic regression analysis was used to identify combined respiratory disease, hemoglobin, albumin, neutrophils, and blood glucose as independent danger factors for perioperative pneumonia (p < 0.05). The nomogram was designed to display the outcomes instinctively, with an ...