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One-Year Mortality After Hip Fracture: Development and Validation of a Prognostic Index.
- Source :
- Journal of the American Geriatrics Society; Sep2016, Vol. 64 Issue 9, p1863-1868, 6p, 4 Charts
- Publication Year :
- 2016
-
Abstract
- Objectives To develop a prediction index for 1-year mortality after hip fracture in older adults that includes predictors from a wide range of domains. Design Retrospective cohort study. Settings Health and Retirement Study ( HRS). Participants HRS participants who experienced hip fracture between 1992 and 2010 as identified according to Medicare claims data (N = 857). Measurements Outcome measure was death within 1 year of hip fracture. Predictor measures were participant demographic characteristics, socioeconomic status, social support, health, geriatric symptoms, and function. Variables independently associated with 1-year mortality were identified, and best-subsets regression was used to identify the final model. The selected variables were weighted to create a risk index. The index was internally validated using bootstrapping to estimate model optimism. Results Mean age at time of hip fracture was 84, and 76% of the participants were women. There were 235 deaths (27%) during the 1-year follow up. Five predictors of mortality were included in the final model: aged 90 and older (2 points), male sex (2 points), congestive heart failure (2 points), difficulty preparing meals (2 points), and not being able to drive (1 point). The point scores of the index were associated with 1-year mortality, with 0 points predicting 10% risk and 7 to 9 points predicting 66% risk. The c-statistic for the final model was 0.73, with an estimated optimism penalty of 0.01, indicating very little evidence of overfitting. Conclusion The prognostic index combines demographic, comorbidity, and function variables and can be used to differentiate between individuals at low and high risk of 1-year mortality after hip fracture. [ABSTRACT FROM AUTHOR]
- Subjects :
- DEATH forecasting
HIP fractures
OLDER people's injuries
MEDICARE claims administration
MORTALITY
PROGNOSIS
DEMOGRAPHIC characteristics
STATISTICS
MORTALITY risk factors
BONE fractures -- Prognosis
AGE distribution
GERIATRIC assessment
AUTOMOBILE driving
CONFIDENCE intervals
COOKING
EXPERIMENTAL design
BONE fractures
HEALTH status indicators
HEART failure
HIP joint injuries
RESEARCH methodology
PROBABILITY theory
REGRESSION analysis
RESEARCH funding
SEX distribution
COMORBIDITY
SOCIAL support
SOCIOECONOMIC factors
RETROSPECTIVE studies
RESEARCH methodology evaluation
DESCRIPTIVE statistics
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 00028614
- Volume :
- 64
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 118169816
- Full Text :
- https://doi.org/10.1111/jgs.14237