Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical Approaches
Hip fracture is a major health issue that accompanies community aging. The most critical time after a hip fracture should be the first year. Care systems and surgical techniques for hip fractures have improved, so the trend of mortality in elderly hip fracture could be changed with them. Therefore,...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-09-01
|
| Series: | Applied Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3417/10/19/6787 |
| _version_ | 1827705303447109632 |
|---|---|
| author | Chia-Lun Lo Ya-Hui Yang Chien-Jen Hsu Chun-Yu Chen Wei-Chun Huang Pei-Ling Tang Jenn-Huei Renn |
| author_facet | Chia-Lun Lo Ya-Hui Yang Chien-Jen Hsu Chun-Yu Chen Wei-Chun Huang Pei-Ling Tang Jenn-Huei Renn |
| author_sort | Chia-Lun Lo |
| collection | DOAJ |
| description | Hip fracture is a major health issue that accompanies community aging. The most critical time after a hip fracture should be the first year. Care systems and surgical techniques for hip fractures have improved, so the trend of mortality in elderly hip fracture could be changed with them. Therefore, we observed the changes in the trend and critical factors for first-year mortality for the hip fractures in an elderly population in Taiwan, and mortality of prognosis prediction model was developed for the early diagnosis using a population-based database in Taiwan (National Health Insurance Research Database, NHIRD). A total of 166,274 elderly subjects with an age greater than 60-years-old from 2001 to 2010 were collected for this study. Cox proportional-hazards (PH) regression and logistic regression were calculated to odds ratio and hazard ratio for mortality of those patients and compared it. Data mining algorithms were also used to generate a risk stratification prediction model. The first-year mortality rate of the overall study group was 21.5% in 2001 and 15.0% in 2010 (<i>p</i> for trend < 0.001). In the male subgroup, the first-year mortality rate was 29.3% in 2001 and decreased to 17.3% in 2010; the trend of standardized mortality ratio was significantly decreased from 4.4 to 2.6 (<i>p</i> for trend < 0.001). By logistic regression, mortality significantly increased with age and male gender. Furthermore, gender, age, patients with diabetes mellitus (DM), cardiovascular (CV), and renal comorbidity, and surgical intervention can be variables for constructing the risk stratification model. The findings of the study will be used for helping related field physicians to predict the prognosis risk of hip fracture patients, and provide evidence-based tailored treatment recommendations for those patients. It may consider to build various models for predicting the prognosis of hip fracture or integrating prediction algorithms into the computerized physician order entry system, thus creating a practical clinical decision support system with warning functions. |
| first_indexed | 2024-03-10T16:00:16Z |
| format | Article |
| id | doaj.art-e13867725cce4fddb05b2539566ee01b |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-10T16:00:16Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-e13867725cce4fddb05b2539566ee01b2023-11-20T15:22:05ZengMDPI AGApplied Sciences2076-34172020-09-011019678710.3390/app10196787Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical ApproachesChia-Lun Lo0Ya-Hui Yang1Chien-Jen Hsu2Chun-Yu Chen3Wei-Chun Huang4Pei-Ling Tang5Jenn-Huei Renn6Department of Health-Business Administration, Fooyin University, Kaohsiung 83102, TaiwanDepartment of Health-Business Administration, Fooyin University, Kaohsiung 83102, TaiwanDepartment of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanDepartment of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanSection of Critical Care and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanResearch Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanDepartment of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanHip fracture is a major health issue that accompanies community aging. The most critical time after a hip fracture should be the first year. Care systems and surgical techniques for hip fractures have improved, so the trend of mortality in elderly hip fracture could be changed with them. Therefore, we observed the changes in the trend and critical factors for first-year mortality for the hip fractures in an elderly population in Taiwan, and mortality of prognosis prediction model was developed for the early diagnosis using a population-based database in Taiwan (National Health Insurance Research Database, NHIRD). A total of 166,274 elderly subjects with an age greater than 60-years-old from 2001 to 2010 were collected for this study. Cox proportional-hazards (PH) regression and logistic regression were calculated to odds ratio and hazard ratio for mortality of those patients and compared it. Data mining algorithms were also used to generate a risk stratification prediction model. The first-year mortality rate of the overall study group was 21.5% in 2001 and 15.0% in 2010 (<i>p</i> for trend < 0.001). In the male subgroup, the first-year mortality rate was 29.3% in 2001 and decreased to 17.3% in 2010; the trend of standardized mortality ratio was significantly decreased from 4.4 to 2.6 (<i>p</i> for trend < 0.001). By logistic regression, mortality significantly increased with age and male gender. Furthermore, gender, age, patients with diabetes mellitus (DM), cardiovascular (CV), and renal comorbidity, and surgical intervention can be variables for constructing the risk stratification model. The findings of the study will be used for helping related field physicians to predict the prognosis risk of hip fracture patients, and provide evidence-based tailored treatment recommendations for those patients. It may consider to build various models for predicting the prognosis of hip fracture or integrating prediction algorithms into the computerized physician order entry system, thus creating a practical clinical decision support system with warning functions.https://www.mdpi.com/2076-3417/10/19/6787hip-fracturedecision treeelderlyfirst-year mortalitynational population database |
| spellingShingle | Chia-Lun Lo Ya-Hui Yang Chien-Jen Hsu Chun-Yu Chen Wei-Chun Huang Pei-Ling Tang Jenn-Huei Renn Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical Approaches Applied Sciences hip-fracture decision tree elderly first-year mortality national population database |
| title | Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical Approaches |
| title_full | Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical Approaches |
| title_fullStr | Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical Approaches |
| title_full_unstemmed | Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical Approaches |
| title_short | Development of a Mortality Risk Model in Elderly Hip Fracture Patients by Different Analytical Approaches |
| title_sort | development of a mortality risk model in elderly hip fracture patients by different analytical approaches |
| topic | hip-fracture decision tree elderly first-year mortality national population database |
| url | https://www.mdpi.com/2076-3417/10/19/6787 |
| work_keys_str_mv | AT chialunlo developmentofamortalityriskmodelinelderlyhipfracturepatientsbydifferentanalyticalapproaches AT yahuiyang developmentofamortalityriskmodelinelderlyhipfracturepatientsbydifferentanalyticalapproaches AT chienjenhsu developmentofamortalityriskmodelinelderlyhipfracturepatientsbydifferentanalyticalapproaches AT chunyuchen developmentofamortalityriskmodelinelderlyhipfracturepatientsbydifferentanalyticalapproaches AT weichunhuang developmentofamortalityriskmodelinelderlyhipfracturepatientsbydifferentanalyticalapproaches AT peilingtang developmentofamortalityriskmodelinelderlyhipfracturepatientsbydifferentanalyticalapproaches AT jennhueirenn developmentofamortalityriskmodelinelderlyhipfracturepatientsbydifferentanalyticalapproaches |