A study of factors influencing distal radius fractures and predictive modeling in emergency department patients

The aim of this study was to explore the independent risk factors for distal radius fractures in emergency department patients and to establish a corresponding prediction model based on these factors. We retrospectively collected 500 patients with distal radius fractures attending the emergency department of our hospital between January 2020 and December 2024 as an observation group, and selected 500 non-fracture patients attending the emergency department during the same period as a control group. Through univariate analysis and multifactorial logistic regression analysis, we identified independent risk factors for distal radius fracture in the emergency department and constructed a predictive nomogram based on these factors. To assess the performance of the model, we plotted the subjects' work characteristic curves and calculated the area under the curve. In addition, the Hosmer-Lemeshow test was used to assess the goodness-of-fit of the model, and internal validation by Bootstrap method combined with 10-fold cross-validation was performed to further confirm the reliability of the model. In order to fully assess the clinical application value of the model, we also performed calibration curve analysis and decision curve analysis. The results of univariate and multivariate logistic regression showed that 5 variables were independent risk factors for distal radius fracture, specifically: age >60 years (OR, 2.862; 95% CI, 1.287-7.764), women (OR, 4.442; 95% CI, 2.074-9.463), sedentary (OR, 1.457; 95% CI, 1.137-2.769), osteoporosis (OR, 2.656; 95% CI, 1.323-6.324), and fracture history (OR, 3.439; 95% CI, 1.398-6.932). These factors may provide an important clinical reference for emergency department physicians to quickly assess a patient's fracture risk at the time of presentation. The distal radius fracture prediction model developed in this study demonstrated high prediction accuracy and can help clinicians and public health professionals better identify high-risk patients and develop effective prevention strategies, thereby reducing the burden of distal radius fractures on patients and the healthcare system.