Dietrich Malou-Sophie, Liodakis Emmanouil, Sehmisch Stephan, Winkelmann Marcel, Gogol Manfred
Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, Hannover, 30625, Germany.
Department of Trauma Surgery, Hannover Medical School, Hannover, Lower Saxony, Germany.
Geroscience. 2025 Jul 17. doi: 10.1007/s11357-025-01789-1.
This study aimed to develop a laboratory-based frailty index (FI-Lab) to predict 12-month mortality risk in elderly patients following a hip fracture (HF). A retrospective analysis of 235 consecutive patients over 70 years old, who underwent HF surgery, was conducted. The FI-Lab, based on 21 routine blood parameters, was evaluated using Receiver Operating Characteristics, Area Under the Curve (AUC), Kaplan-Meier curves, and Cox proportional Hazard ratios. The FI-Lab showed an AUC of 0.7177 for 6-month and 0.7423 for 1-year survival. High FI-Lab values correlated with higher preoperative ASA scores, longer time-to-surgery times, more perioperative transfusions, and higher postoperative complication rates. The Cox hazard ratio revealed a significant increase in the risk of death for 1 year and 6 months from a score of 0.4 and higher. These findings highlight the FI-Lab's clinical relevance and validity as a predictive tool, emphasizing the need for differentiated perioperative risk stratification.
本研究旨在开发一种基于实验室的衰弱指数(FI-Lab),以预测老年髋部骨折(HF)患者12个月的死亡风险。对235例70岁以上接受HF手术的连续患者进行了回顾性分析。基于21项常规血液参数的FI-Lab,采用受试者工作特征曲线、曲线下面积(AUC)、Kaplan-Meier曲线和Cox比例风险比进行评估。FI-Lab在6个月生存时的AUC为0.7177,1年生存时为0.7423。高FI-Lab值与术前较高的美国麻醉医师协会(ASA)评分、较长的手术等待时间、更多的围手术期输血以及较高的术后并发症发生率相关。Cox风险比显示,从0.4分及以上开始,1年和6个月的死亡风险显著增加。这些发现突出了FI-Lab作为一种预测工具的临床相关性和有效性,强调了进行差异化围手术期风险分层的必要性。