Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: a prospective cohort study

BackgroundThe prediction of postoperative complications is vital in the management of hip fracture. This study specifically examined the occurrence of multiple organ dysfunction syndrome in the elderly (MODSE) following hip fracture surgery and explored its predictive model and correlation with long...

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Main Authors: Lei Liu, Yang Deng, Zhijun Qin, Ying Zhang, Xi Yang, Ji Feng, Chenzhu Yin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1515557/full
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author Lei Liu
Yang Deng
Zhijun Qin
Ying Zhang
Xi Yang
Ji Feng
Chenzhu Yin
author_facet Lei Liu
Yang Deng
Zhijun Qin
Ying Zhang
Xi Yang
Ji Feng
Chenzhu Yin
author_sort Lei Liu
collection DOAJ
description BackgroundThe prediction of postoperative complications is vital in the management of hip fracture. This study specifically examined the occurrence of multiple organ dysfunction syndrome in the elderly (MODSE) following hip fracture surgery and explored its predictive model and correlation with long-term mortality.MethodsThis prospective cohort study included all patients aged 80 years and older who underwent hip fracture surgery at a tertiary orthopedic hospital between January 2020 and March 2021. The patients were categorized into the MODSE and non-MODSE groups. The pre, peri, and postoperative variables were retrospectively screened to establish and validate prediction model for MODSE. The patients were subsequently followed up prospectively until 2 years after discharge in order to explore the association between MODSE and long-term mortality.ResultsSignificant discrepancies in clinical characteristics were observed between MODSE and non-MODSE patients. Those with a preoperative age-adjusted Charlson Comorbidity Index > 5, Impaired swallowing, an Acute Physiology and Chronic Health Evaluation II score ≥ 12 within the initial 24 h post-surgery, prothrombin time > 14 s, along with high-sensitivity cardiac troponin T > 14 pg./mL and procalcitonin levels > 0.25 ng/mL on the first day after surgery were found to have a higher likelihood of developing MODSE. Moreover, the presence of MODSE correlated with a 3.13-fold and 2.88-fold increased risk of mortality at 1 and 2 years post-discharge, respectively.ConclusionPredicting postoperative MODSE in elderly hip fracture patients is essential and feasible, as its occurrence represents poor outcome during hospitalization and predicts heightened long-term mortality rates.
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spelling doaj-art-e2bd3bd3662145aea1d7283090e4cfbf2025-08-20T03:13:41ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15155571515557Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: a prospective cohort studyLei Liu0Yang Deng1Zhijun Qin2Ying Zhang3Xi Yang4Ji Feng5Chenzhu Yin6Hospital Infection Management Department, Sichuan Province Orthopedic Hospital, Chengdu, ChinaIntensive Care Unit, Sichuan Province Orthopedic Hospital, Chengdu, ChinaAnesthesiology Department, Sichuan Province Orthopedic Hospital, Chengdu, ChinaIntensive Care Unit, Sichuan Province Orthopedic Hospital, Chengdu, ChinaIntensive Care Unit, Sichuan Province Orthopedic Hospital, Chengdu, ChinaAnesthesiology Department, Sichuan Province Orthopedic Hospital, Chengdu, ChinaAnesthesiology Department, Sichuan Province Orthopedic Hospital, Chengdu, ChinaBackgroundThe prediction of postoperative complications is vital in the management of hip fracture. This study specifically examined the occurrence of multiple organ dysfunction syndrome in the elderly (MODSE) following hip fracture surgery and explored its predictive model and correlation with long-term mortality.MethodsThis prospective cohort study included all patients aged 80 years and older who underwent hip fracture surgery at a tertiary orthopedic hospital between January 2020 and March 2021. The patients were categorized into the MODSE and non-MODSE groups. The pre, peri, and postoperative variables were retrospectively screened to establish and validate prediction model for MODSE. The patients were subsequently followed up prospectively until 2 years after discharge in order to explore the association between MODSE and long-term mortality.ResultsSignificant discrepancies in clinical characteristics were observed between MODSE and non-MODSE patients. Those with a preoperative age-adjusted Charlson Comorbidity Index > 5, Impaired swallowing, an Acute Physiology and Chronic Health Evaluation II score ≥ 12 within the initial 24 h post-surgery, prothrombin time > 14 s, along with high-sensitivity cardiac troponin T > 14 pg./mL and procalcitonin levels > 0.25 ng/mL on the first day after surgery were found to have a higher likelihood of developing MODSE. Moreover, the presence of MODSE correlated with a 3.13-fold and 2.88-fold increased risk of mortality at 1 and 2 years post-discharge, respectively.ConclusionPredicting postoperative MODSE in elderly hip fracture patients is essential and feasible, as its occurrence represents poor outcome during hospitalization and predicts heightened long-term mortality rates.https://www.frontiersin.org/articles/10.3389/fmed.2025.1515557/fullelderlyhip fracture surgerymultiple organ dysfunction syndromemortalityprediction model
spellingShingle Lei Liu
Yang Deng
Zhijun Qin
Ying Zhang
Xi Yang
Ji Feng
Chenzhu Yin
Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: a prospective cohort study
Frontiers in Medicine
elderly
hip fracture surgery
multiple organ dysfunction syndrome
mortality
prediction model
title Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: a prospective cohort study
title_full Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: a prospective cohort study
title_fullStr Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: a prospective cohort study
title_full_unstemmed Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: a prospective cohort study
title_short Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: a prospective cohort study
title_sort clinical prediction model and 2 year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery a prospective cohort study
topic elderly
hip fracture surgery
multiple organ dysfunction syndrome
mortality
prediction model
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1515557/full
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