Journal Article

All-Cause Mortality Risk in Elderly Patients with Femoral Neck and Intertrochanteric Fractures: A Predictive Model Based on Machine Learning

Liu, Yan, Hou, Zhiyong, Min, Aoying, Fu, Mingming, Wang, Zhiqian

2025

Overview

The aim of this study was to identify the influencing factors for all-cause mortality in elderly patients with intertrochanteric and femoral neck fractures and to construct predictive models. This study retrospectively collected elderly patients with intertrochanteric fractures and femoral neck fractures who underwent hip fractures surgery in the Third Hospital of Hebei Medical University from January 2020 to December 2022. Cox proportional hazards regression is used to explore the association between fractures type and mortality. Boruta algorithm was used to screen the risk factors related to death. Multivariate logistic regression was used to determine the independent risk factors, and a nomogram prediction model was established. The ROC curve, calibration curve and DCA decision curve were drawn by R language, and the prediction model was established by machine learning algorithm. Among the 1373 patients. There were 6 variables that remained in the model for intertrochanteric fractures: age (HR 1.048, 95% CI 1.014-1.083, p = 0.006), AMI (HR 4.631, 95% CI 2.190-9.795, P < 0.001), COPD (HR 3.818, 95% CI 1.516-9.614, P = 0.004), CHF (HR 2.743, 95% CI 1.510-4.981, P = 0.001), NOAF (HR 1.748, 95% CI 1.033-2.956, P = 0.037), FBG (HR 1.116, 95% CI 1.026-1.215, P = 0.011). There were 3 variables that remained in the model for femoral neck fractures: age (HR 1.145, 95% CI 1.097-1.196, P < 0.001), HbA1c (HR 1.264, 95% CI 1.088-1.468, P = 0.002), BNP (HR 1.001, 95% CI 1.000-1.002, P = 0.019). The experimental results showed that the model has good identification ability, calibration effect and clinical application value. Intertrochanteric fractures is an independent risk factor for all-cause mortality in elderly patients with hip fractures. By constructing a prognostic model based on machine learning, the risk factors of mortality in patients with intertrochanteric fractures and femoral neck fractures can be effectively identified, and personalized treatment strategies can be developed.

• Publisher: Dove Medical Press Limited,Taylor & Francis Ltd,Dove Press,Dove,Dove Medical Press
• Subject: Age / Aged / Aged patients / Aged, 80 and over / Algorithms / Anemia / Anesthesia / boruta algorithm / Cardiac arrhythmia / Cardiovascular disease / China / Chronic obstructive pulmonary disease / Decision making / Delirium / Diabetes / Feature selection / Female / femoral neck fractures / Femoral Neck Fractures - mortality / Femoral Neck Fractures - surgery / Femur / Fractures / Health risks / Heart attacks / Hip Fractures - mortality / Hip Fractures - surgery / Humans / Hypertension / Hyponatremia / Injuries / intertrochanteric fractures / Ischemia / Machine Learning / Male / Medical colleges / Medical research / Medicine, Experimental / Mortality / Mortality、Intertrochanteric fractures、Femoral neck fractures、Boruta algorithm、Machine learning、Prediction model / Nomograms / Older people / Original Research / Osteoporosis / Patient outcomes / Physiological aspects / Pneumonia / prediction model / Proportional Hazards Models / Regression analysis / Retrospective Studies / Risk Assessment - methods / Risk Factors / Statistical analysis / Surgery / Variables