Li Yi-Ping, Xu Mei, Xie Hao-Fen, Zhu Ying-Chun
Department of Orthopaedic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, 315010, People's Republic of China.
Department of Nursing, First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, 315010, People's Republic of China.
J Multidiscip Healthc. 2024 Dec 30;17:6177-6186. doi: 10.2147/JMDH.S487495. eCollection 2024.
To evaluate the risk factors contributing to preoperative malnutrition in elderly patients with hip fractures.
The study retrospectively analysed clinical data from 182 elderly patients aged 60 years or older with hip fractures. Nutritional status was assessed according to the Global Leadership Initiative on Malnutrition diagnostic criteria, and risk factors associated with malnutrition were identified through univariate and logistic regression analyses. Based on the findings, a nomogram was developed, and a calibration curve model was constructed. The predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve. Finally, the model was validated using an independent cohort of 78 patients.
Data analysis revealed that among the 182 elderly patients with hip fractures, 76 were men and 106 were women, with a mean age of 75.77 ± 8.66 years. The fractures included 135 femoral neck fractures and 47 intertrochanteric fractures. Malnutrition was identified in 39.01% (71/182) of the patients. Independent risk factors for malnutrition included age, body mass index, the number of comorbidities, haemoglobin level and serum albumin level. A nomogram model incorporating these indicators was developed, demonstrating robust predictive performance, with an area under the ROC curve of 0.886 (95% confidence interval: 0.809-0.962).
It is anticipated that the proposed model will serve as a valuable tool for the timely and accurate clinical identification of malnutrition risk in elderly patients with hip fractures.
评估老年髋部骨折患者术前营养不良的危险因素。
本研究回顾性分析了182例60岁及以上老年髋部骨折患者的临床资料。根据全球营养不良领导倡议诊断标准评估营养状况，并通过单因素和逻辑回归分析确定与营养不良相关的危险因素。基于研究结果，绘制了列线图，并构建了校准曲线模型。使用受试者工作特征（ROC）曲线评估模型的预测性能。最后，使用78例患者的独立队列对模型进行验证。
数据分析显示，182例老年髋部骨折患者中，男性76例，女性106例，平均年龄75.77±8.66岁。骨折类型包括135例股骨颈骨折和47例转子间骨折。39.01%（71/182）的患者存在营养不良。营养不良的独立危险因素包括年龄、体重指数、合并症数量、血红蛋白水平和血清白蛋白水平。构建了包含这些指标的列线图模型，其预测性能良好，ROC曲线下面积为0.886（95%置信区间：0.809-0.962）。
预期所提出的模型将成为及时、准确临床识别老年髋部骨折患者营养不良风险的有价值工具。
