Dementia is a surrogate for frailty in hip fracture mortality prediction

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Forssten, Maximilian Peter,1996-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedics Surgery, Örebro University Hospital, Örebro, Sweden (författare)

Dementia is a surrogate for frailty in hip fracture mortality prediction

Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

2022-03-30
Springer,2022
printrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:oru-98420
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-98420URI
https://doi.org/10.1007/s00068-022-01960-9DOI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:ref swepub-contenttype
Ämneskategori:art swepub-publicationtype

Anmärkningar

Funding agency:Örebro University
PURPOSE: Among hip fracture patients both dementia and frailty are particularly prevalent. The aim of the current study was to determine if dementia functions as a surrogate for frailty, or if it confers additional information as a comorbidity when predicting postoperative mortality after a hip fracture.METHODS: All adult patients who suffered a traumatic hip fracture in Sweden between January 1, 2008 and December 31, 2017 were considered for inclusion. Pathological fractures, non-operatively treated fractures, reoperations, and patients missing data were excluded. Logistic regression (LR) models were fitted, one including and one excluding measurements of frailty, with postoperative mortality as the response variable. The primary outcome of interest was 30-day postoperative mortality. The relative importance for all variables was determined using the permutation importance. New LR models were constructed using the top ten most important variables. The area under the receiver-operating characteristic curve (AUC) was used to compare the predictive ability of these models.RESULTS: 121,305 patients were included in the study. Initially, dementia was among the top ten most important variables for predicting 30-day mortality. When measurements of frailty were included, dementia was replaced in relative importance by the ability to walk alone outdoors and institutionalization. There was no significant difference in the predictive ability of the models fitted using the top ten most important variables when comparing those that included [AUC for 30-day mortality (95% CI): 0.82 (0.81-0.82)] and excluded [AUC for 30-day mortality (95% CI): 0.81 (0.80-0.81)] measurements of frailty.CONCLUSION: Dementia functions as a surrogate for frailty when predicting mortality up to one year after hip fracture surgery. The presence of dementia in a patient without frailty does not appreciably contribute to the prediction of postoperative mortality.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng
Dementia
Frailty
Hip fracture
Logistic regression
Mortality prediction
Permutation importance

Biuppslag (personer, institutioner, konferenser, titlar ...)

Ioannidis, Ioannis,1967-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedics Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)iis (författare)
Mohammad Ismail, Ahmad,1993-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Orthopedics Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)aml (författare)
Bass, Gary Alan,1979-Örebro universitet,Institutionen för medicinska vetenskaper,Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Penn Presbyterian Medical Center, Philadelphia, PA, USA(Swepub:oru)gbs (författare)
Borg, Tomas,1963-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Orthopedics Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)tbg (författare)
Cao, Yang,Associate Professor,1972-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län(Swepub:oru)yco (författare)
Mohseni, Shahin,1978-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)snmi (författare)
Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

Sammanhörande titlar

Ingår i:European Journal of Trauma and Emergency Surgery: Springer48:5, s. 4157-41671863-99331863-9941

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European Journal of Trauma and Emergency Surgery (Sök värdpublikationen i LIBRIS)

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Av lärosätet: Örebro universitet

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