ABSTRACT
BACKGROUND:
With a gradually
aging population,improving the
ability to screen for the
risk of
death after
arthroplasty and implementing timely personalized intervention programs for the increasing number of
elderly patients with
femoral neck fractures is key to improving the postoperative status of
patients and prolonging
survival expectations.
OBJECTIVE:
To investigate the
risk factors for postoperative
mortality in
elderly patients with
femoral neck fractures and to construct a
nomogram predictive model to predict their
mortality risk.
METHODS:
The study was conducted on 155
elderly patients(≥65 years old)
who underwent
arthroplasty for
femoral neck fracture from January 2016 to January 2021,and 147
patients who met the inclusion criteria were analyzed to collect clinical data that may
affect the
patients'postoperative
mortality.Single-factor and multi-factor Cox
regression analyses were successively used to screen independent
risk factors associated with postoperative
mortality.The column line graph model was constructed and validated using Rstudio
software. RESULTS AND
CONCLUSION:
(1)Age,
frailty(age-adjusted Charlson comorbidities score),preoperative activity status,
osteoporosis,and postoperative
serum albumin level were five independent
risk factors for postoperative
mortality in
elderly patients with
femoral neck fractures(P<0.05).(2)The
nomogram predictive model was constructed based on the results of multifactorial
analysis,with a consistency index of 0.819(95%CI0.771-0.868).
Receiver operating characteristic curve
analysis showed that the
area under curve for 1-year and 3-year
survival prediction was 0.8543 and 0.7263,respectively,indicating that the
nomogram predictive model has good discriminatory and predictive
power;
calibration curve and
decision curve
analysis also showed good model discriminative
power and clinical utility value.(3)The constructed
nomogram predictive model has good diagnostic
efficacy and accuracy,and can effectively assess the
risk of postoperative
death of
patients.