Development and Internal Validation of a Prediction Model for In-Hospital Mortality in Geriatric Patients With a Hip Fracture.

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.