Evaluating the impact of Age-Adjusted Charlson Comorbidity Index on in-hospital complications in patients with femoral fracture: a retrospective cohort analysis from the MIMIC-IV 2.2 database.

BACKGROUND

Femoral fractures in hospitalized patients often lead to limited mobility, increasing the risk of complications like deep venous thrombosis (DVT), pressure ulcers, and delirium. These risks are particularly pronounced in elderly patients with multiple comorbidities. Monitoring such patients using reliable indices like the Age-Adjusted Charlson Comorbidity Index (ACCI) can help in early identification and management of these risks. This study investigates the association between ACCI scores and the incidence of in-hospital complications DVT, pressure ulcers, delirium in patients with femoral fractures.

METHODS

Using the MIMIC-IV 2.2 database, we extracted data for 4,134 patients diagnosed with femoral fractures after applying exclusion criteria such as repeated admissions, age under 18, and significant missing data. ACCI and other demographic and clinical data were used in logistic regression models and restricted cubic spline (RCS) analyses to assess the relationship between ACCI and complication risks.

RESULTS

A nonlinear association between ACCI and complication risk was identified, with significant risk increases beyond an ACCI of 5. Patients were divided into low-ACCI (≤5) and high-ACCI (>5) groups. High-ACCI patients had significantly greater risks of developing DVT (OR = 2.151), pressure ulcers (OR = 2.168), and delirium (OR = 1.791), compared to low-ACCI patients, indicating ACCI's effectiveness in predicting these complications.

CONCLUSION

ACCI is a valuable tool for predicting the risk of in-hospital complications among femoral fracture patients, facilitating targeted interventions and improved patient management.