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Development and Internal Validation of a Prediction Model for In-Hospital Mortality in Geriatric Patients With a Hip
Henk Jan Schuijt1,2,3, Diederik P J Smeeing1, Franka S Würdemann4,5
1Department of Surgery, Sint Antonius Hospital, Utrecht, the Netherlands.
Objective:
To develop and validate a prediction model for in-hospital mortality in patients with hip fracture 85 years of age or older undergoing surgery.
Design:
A multicenter prospective cohort study.
Setting:
Six Dutch trauma centers, level 2 and 3.
Participants:
Patients with hip fracture 85 years of age or older undergoing surgery.
Intervention:
Hip fracture surgery.
Main Outcome Measurements:
In-hospital mortality.
Results:
The development cohort consisted of 1014 patients. In-hospital mortality was 4%. Age, male sex, American Society of Anesthesiologists classification, and hemoglobin levels at presentation were independent predictors of in-hospital mortality. The bootstrap adjusted performance showed good discrimination with a c-statistic of 0.77.
Conclusion:
Age, male sex, higher American Society of Anesthesiologists classification, and lower hemoglobin levels at presentation are robust independent predictors of in-hospital mortality in patients with geriatric hip fracture and were incorporated in a simple prediction model with good accuracy and no lack of fit.
Level Of Evidence:
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
