Development and temporal external validation of a novel nomogram for predicting one-year mortality in the older adult with hip fracture
ObjectiveThe aim of this study was to develop a novel nomogram for predicting one-year mortality in the older adult patients with hip fracture and to further evaluate its effectiveness.MethodsThis retrospective cohort research analyzed the clinical data of 1,263 older adult patients with hip fractur...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1532196/full |
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| author | Yangfan Gong Kai Zhang Wei Chen Qiqi Yang Mingyue Shi Zhao Dong Zhuohao Yin Yuyu Zhang Wei Ge |
| author_facet | Yangfan Gong Kai Zhang Wei Chen Qiqi Yang Mingyue Shi Zhao Dong Zhuohao Yin Yuyu Zhang Wei Ge |
| author_sort | Yangfan Gong |
| collection | DOAJ |
| description | ObjectiveThe aim of this study was to develop a novel nomogram for predicting one-year mortality in the older adult patients with hip fracture and to further evaluate its effectiveness.MethodsThis retrospective cohort research analyzed the clinical data of 1,263 older adult patients with hip fractures who underwent surgery at the First Affiliated Hospital of Air Force Military Medical University from January 2014 to December 2022. Patients receiving surgical treatment during January 2014 to December 2019 (864 cases) for the model development and further, data from the same centre with same inclusion criteria from January 2020 to December 2022 (399 cases) for the external validation of the model. The univariate and multivariable logistic regression were utilized to identify independent risk factors linked to one-year mortality. A predictive nomogram was subsequently developed. The discriminatory power of the model and its accuracy were monitored by utilizing receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis. Furthermore, visual risk applications were developed to enhance usability.ResultsThe one-year mortality is 16.8%. A total of seven predictors, namely age, body mass index (BMI), fibrinogen (FIB), stroke, dementia, ASA (American Society of Anesthesiologists), intraoperative blood transfusion were identified by multivariate analysis from a total of 65 variables studied. The model constructed using these seven predictors displayed medium prediction ability, with an area under the ROC of 0.775 in the training set and 0.740 in the validation set. The calibration curve shows a good degree of fitting between the predicted and observed probabilities. The DCA curve showed that the nomogram could be applied clinically if the risk threshold was between 8 and 64%, which was found to be between 6 and 80% in the external validation.ConclusionIndependent factors, including age, BMI, preoperative fibrinogen level, stroke, dementia, ASA, intraoperative blood transfusion are pivotal in influencing one-year survival rate for patients with hip fractures. This risk dynamic nomogram developed from these factors renders substantial predictive accuracy and clinical utility, providing a reliable basis for a reasonable and personalized treatment plan. |
| format | Article |
| id | doaj-art-1f616d623f374dbd85b4f235cd358a7d |
| institution | OA Journals |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-1f616d623f374dbd85b4f235cd358a7d2025-08-20T01:55:37ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15321961532196Development and temporal external validation of a novel nomogram for predicting one-year mortality in the older adult with hip fractureYangfan Gong0Kai Zhang1Wei Chen2Qiqi Yang3Mingyue Shi4Zhao Dong5Zhuohao Yin6Yuyu Zhang7Wei Ge8Department of General Practice, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDepartment of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDepartment of General Practice, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDepartment of General Practice, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDepartment of General Practice, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDepartment of General Practice, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDepartment of General Practice, Xijing Hospital, Air Force Medical University, Xi’an, ChinaDepartment of General Practice, Xijing Hospital, Air Force Medical University, Xi’an, ChinaObjectiveThe aim of this study was to develop a novel nomogram for predicting one-year mortality in the older adult patients with hip fracture and to further evaluate its effectiveness.MethodsThis retrospective cohort research analyzed the clinical data of 1,263 older adult patients with hip fractures who underwent surgery at the First Affiliated Hospital of Air Force Military Medical University from January 2014 to December 2022. Patients receiving surgical treatment during January 2014 to December 2019 (864 cases) for the model development and further, data from the same centre with same inclusion criteria from January 2020 to December 2022 (399 cases) for the external validation of the model. The univariate and multivariable logistic regression were utilized to identify independent risk factors linked to one-year mortality. A predictive nomogram was subsequently developed. The discriminatory power of the model and its accuracy were monitored by utilizing receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis. Furthermore, visual risk applications were developed to enhance usability.ResultsThe one-year mortality is 16.8%. A total of seven predictors, namely age, body mass index (BMI), fibrinogen (FIB), stroke, dementia, ASA (American Society of Anesthesiologists), intraoperative blood transfusion were identified by multivariate analysis from a total of 65 variables studied. The model constructed using these seven predictors displayed medium prediction ability, with an area under the ROC of 0.775 in the training set and 0.740 in the validation set. The calibration curve shows a good degree of fitting between the predicted and observed probabilities. The DCA curve showed that the nomogram could be applied clinically if the risk threshold was between 8 and 64%, which was found to be between 6 and 80% in the external validation.ConclusionIndependent factors, including age, BMI, preoperative fibrinogen level, stroke, dementia, ASA, intraoperative blood transfusion are pivotal in influencing one-year survival rate for patients with hip fractures. This risk dynamic nomogram developed from these factors renders substantial predictive accuracy and clinical utility, providing a reliable basis for a reasonable and personalized treatment plan.https://www.frontiersin.org/articles/10.3389/fmed.2025.1532196/fullolder adulthip fracturerisk factorsnomogram modelone-year mortality |
| spellingShingle | Yangfan Gong Kai Zhang Wei Chen Qiqi Yang Mingyue Shi Zhao Dong Zhuohao Yin Yuyu Zhang Wei Ge Development and temporal external validation of a novel nomogram for predicting one-year mortality in the older adult with hip fracture Frontiers in Medicine older adult hip fracture risk factors nomogram model one-year mortality |
| title | Development and temporal external validation of a novel nomogram for predicting one-year mortality in the older adult with hip fracture |
| title_full | Development and temporal external validation of a novel nomogram for predicting one-year mortality in the older adult with hip fracture |
| title_fullStr | Development and temporal external validation of a novel nomogram for predicting one-year mortality in the older adult with hip fracture |
| title_full_unstemmed | Development and temporal external validation of a novel nomogram for predicting one-year mortality in the older adult with hip fracture |
| title_short | Development and temporal external validation of a novel nomogram for predicting one-year mortality in the older adult with hip fracture |
| title_sort | development and temporal external validation of a novel nomogram for predicting one year mortality in the older adult with hip fracture |
| topic | older adult hip fracture risk factors nomogram model one-year mortality |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1532196/full |
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