Risk factors for short-term mortality in elderly hip fracture patients with complicated heart failure in the ICU: A MIMIC-IV database analysis using nomogram
Abstract Background Hip fracture is a prevalent and hazardous injury among the elderly population that often results in intensive care unit (ICU) admission due to various complications, despite advanced medical science. One common complication experienced in the ICU by elderly hip fracture patients...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-04258-7 |
| _version_ | 1797636757247754240 |
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| author | Yining Lu Wei Chen Yuhui Guo Yujing Wang Ling Wang Yingze Zhang |
| author_facet | Yining Lu Wei Chen Yuhui Guo Yujing Wang Ling Wang Yingze Zhang |
| author_sort | Yining Lu |
| collection | DOAJ |
| description | Abstract Background Hip fracture is a prevalent and hazardous injury among the elderly population that often results in intensive care unit (ICU) admission due to various complications, despite advanced medical science. One common complication experienced in the ICU by elderly hip fracture patients is heart failure, which significantly impacts short-term survival rates. Currently, there is a deficit of adequate predictive models to forecast the short-term risk of death following heart failure for elderly hip fracture patients in the ICU. This study aims to identify independent risk factors for all-cause mortality within 30 days for elderly patients with hip fractures and heart failure while in the ICU in order to develop a predictive model. Method A total of 641 elderly patients with hip fractures combined with heart failure were recruited from the Medical Information Mart for Intensive Care IV dataset and randomized to the training and validation sets. The primary outcome was all-cause mortality within 30 days. The least absolute shrinkage and selection operator regression was used to reduce data dimensionality and select features. Multivariate logistic regression was used to build predictive models. Consistency index (C-index), receiver operating characteristic curve, and decision curve analysis (DCA) were used to measure the predictive performance of the nomogram. Result Our results showed that these variables including MCH, MCV, INR, monocyte percentage, neutrophils percentage, creatinine, and combined sepsis were independent factors for death within 30 days in elderly patients with hip fracture combined with heart failure in the ICU. The C-index was 0.869 (95% CI 0.823–0.916) and 0.824 (95% CI 0.749–0.900) for the training and validation sets, respectively. The results of the area under the curve and decision curve analysis (DCA) confirmed that the nomogram performed well in predicting elderly patients with hip fractures combined with heart failure in the ICU. Conclusion We developed a new nomogram model for predicting 30-day all-cause mortality in elderly patients with hip fractures combined with heart failure in the ICU, which could be a valid and useful clinical tool for clinicians for targeted treatment and prognosis prediction. |
| first_indexed | 2024-03-11T12:39:41Z |
| format | Article |
| id | doaj.art-76958dca79d04959a432ea7ade3ce55b |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-11T12:39:41Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-76958dca79d04959a432ea7ade3ce55b2023-11-05T12:24:39ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-11-0118111210.1186/s13018-023-04258-7Risk factors for short-term mortality in elderly hip fracture patients with complicated heart failure in the ICU: A MIMIC-IV database analysis using nomogramYining Lu0Wei Chen1Yuhui Guo2Yujing Wang3Ling Wang4Yingze Zhang5Department of Orthopedic Research Center, The Third Hospital of Hebei Medical UniversityDepartment of Orthopedic Research Center, The Third Hospital of Hebei Medical UniversityDepartment of Orthopedic Research Center, The Third Hospital of Hebei Medical UniversityDepartment of Orthopedic Research Center, The Third Hospital of Hebei Medical UniversityDepartment of Orthopedic Research Center, The Third Hospital of Hebei Medical UniversityDepartment of Orthopedic Research Center, The Third Hospital of Hebei Medical UniversityAbstract Background Hip fracture is a prevalent and hazardous injury among the elderly population that often results in intensive care unit (ICU) admission due to various complications, despite advanced medical science. One common complication experienced in the ICU by elderly hip fracture patients is heart failure, which significantly impacts short-term survival rates. Currently, there is a deficit of adequate predictive models to forecast the short-term risk of death following heart failure for elderly hip fracture patients in the ICU. This study aims to identify independent risk factors for all-cause mortality within 30 days for elderly patients with hip fractures and heart failure while in the ICU in order to develop a predictive model. Method A total of 641 elderly patients with hip fractures combined with heart failure were recruited from the Medical Information Mart for Intensive Care IV dataset and randomized to the training and validation sets. The primary outcome was all-cause mortality within 30 days. The least absolute shrinkage and selection operator regression was used to reduce data dimensionality and select features. Multivariate logistic regression was used to build predictive models. Consistency index (C-index), receiver operating characteristic curve, and decision curve analysis (DCA) were used to measure the predictive performance of the nomogram. Result Our results showed that these variables including MCH, MCV, INR, monocyte percentage, neutrophils percentage, creatinine, and combined sepsis were independent factors for death within 30 days in elderly patients with hip fracture combined with heart failure in the ICU. The C-index was 0.869 (95% CI 0.823–0.916) and 0.824 (95% CI 0.749–0.900) for the training and validation sets, respectively. The results of the area under the curve and decision curve analysis (DCA) confirmed that the nomogram performed well in predicting elderly patients with hip fractures combined with heart failure in the ICU. Conclusion We developed a new nomogram model for predicting 30-day all-cause mortality in elderly patients with hip fractures combined with heart failure in the ICU, which could be a valid and useful clinical tool for clinicians for targeted treatment and prognosis prediction.https://doi.org/10.1186/s13018-023-04258-730-day all-cause mortalityGeriatric hip fracturesHeart failureNomogramInfectionNeutrophils |
| spellingShingle | Yining Lu Wei Chen Yuhui Guo Yujing Wang Ling Wang Yingze Zhang Risk factors for short-term mortality in elderly hip fracture patients with complicated heart failure in the ICU: A MIMIC-IV database analysis using nomogram Journal of Orthopaedic Surgery and Research 30-day all-cause mortality Geriatric hip fractures Heart failure Nomogram Infection Neutrophils |
| title | Risk factors for short-term mortality in elderly hip fracture patients with complicated heart failure in the ICU: A MIMIC-IV database analysis using nomogram |
| title_full | Risk factors for short-term mortality in elderly hip fracture patients with complicated heart failure in the ICU: A MIMIC-IV database analysis using nomogram |
| title_fullStr | Risk factors for short-term mortality in elderly hip fracture patients with complicated heart failure in the ICU: A MIMIC-IV database analysis using nomogram |
| title_full_unstemmed | Risk factors for short-term mortality in elderly hip fracture patients with complicated heart failure in the ICU: A MIMIC-IV database analysis using nomogram |
| title_short | Risk factors for short-term mortality in elderly hip fracture patients with complicated heart failure in the ICU: A MIMIC-IV database analysis using nomogram |
| title_sort | risk factors for short term mortality in elderly hip fracture patients with complicated heart failure in the icu a mimic iv database analysis using nomogram |
| topic | 30-day all-cause mortality Geriatric hip fractures Heart failure Nomogram Infection Neutrophils |
| url | https://doi.org/10.1186/s13018-023-04258-7 |
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