Development and validation of a preoperative scoring system to predict 30 day mortality in patients undergoing hip fracture surgery
Development and validation of a preoperative scoring system to predict 30 day mortality in patients undergoing hip fracture surgery
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DOI：
10.1093/bja/aen236
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发表时间：
2008-10-01
影响因子：
9.8
通讯作者：
Moppett, I. K.
中科院分区：
文献类型：
--
作者：
Maxwell, M. J.;Moran, C. G.;Moppett, I. K.
背景资料。髋部骨折在老年人中很常见，术后30天死亡率很高。术前识别预后不良的高危患者的能力将是一项重要的临床进步。这项研究确定了预测髋部骨折人群30天死亡率的关键预后因素，并将它们纳入入院时使用的评分系统。一项队列研究在诺丁汉女王医疗中心进行，历时7年。收集了4967名患者的完整数据并进行了分析。采用前向单因素Logistic回归方法筛选出影响30d死亡率的独立预测变量，然后对数据进行多元Logistic回归分析，构建并验证评分体系。被发现的独立预测30天死亡率的变量是：年龄(66-85岁，=86岁)，性别(男性)，合并疾病的数量(=2)，简易智力测试分数(
Background. Hip fractures are common in the elderly and have a high 30 day postoperative mortality. The ability to recognize patients at high risk of poor outcomes before operation would be an important clinical advance. This study has determined key prognostic factors predicting 30 day mortality in a hip fracture population, and incorporated them into a scoring system to be used on admission.Methods. A cohort study was conducted at the Queen's Medical Centre, Nottingham, over a period of 7 yr. Complete data were collected from 4967 patients and analysed. Forward univariate logistic regression was used to select the independent predictor variables of 30 day mortality, and then multivariate logistic regression was applied to the data to construct and validate the scoring system.Results. The variables found to be independent predictors of mortality at 30 days were: age (66-85 yr, >= 86 yr), sex (male), number of co-morbidities (>= 2), mini-mental test score (