The Geriatrics at Risk Score (GeRi-Score) for mortality prediction in geriatric patients with proximal femur fracture - a development and validation study from the Registry for Geriatric Trauma (ATR-DGU).

Autor: Schoeneberg C; Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany. carsten.schoeneberg@krupp-krankenhaus.de., Heuser L; Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany., Rascher K; AUC, Academy for Trauma Surgery (AUC), Munich, Germany., Lendemans S; Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany., Knobe M; Medical Faculty, University of Zurich, Zurich, Switzerland.; Medical Faculty, RWTH Aachen University Hospital, 52074, Aachen, Germany., Eschbach D; Center for Orthopedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany., Buecking B; Department for Trauma Surgery, Klinikum Hochsauerland, Arnsberg, Germany., Liener U; Department of Orthopedics and Trauma Surgery, Marienhospital, Stuttgart, Germany., Neuerburg C; Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU, Munich, Germany., Pass B; Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany., Schmitz D; Department of Trauma, Orthopedic and Hand Surgery, Marienhospital Bottrop, Bottrop, Germany.
Jazyk: angličtina
Zdroj: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2023 May; Vol. 34 (5), pp. 879-890. Date of Electronic Publication: 2023 Mar 09.
DOI: 10.1007/s00198-023-06719-5
Abstrakt: This study developed an easy-to-use mortality prediction tool, which showed an acceptable discrimination and no significant lack of fit. The GeRi-Score was able to predict mortality and could distinguish between mild, moderate and high risk groups. Therefore, the GeRi-Score might have the potential to distribute the intensity of medical care.
Purpose: Several mortality-predicting tools for hip fracture patients are available, but all consist of a high number of variables, require a time-consuming evaluation and/or are difficult to calculate. The aim of this study was to develop and validate an easy-to-use score, which depends mostly on routine data.
Methods: Patients from the Registry for Geriatric Trauma were divided into a development and a validation group. Logistic regression models were used to build a model for in-house mortality and to obtain a score. Candidate models were compared using Akaike information criteria (AIC) and likelihood ratio tests. The quality of the model was tested using the area under the curve (AUC) and the Hosmer-Lemeshow test.
Results: 38,570 patients were included, almost equal distributed to the development and to the validation dataset. The AUC was 0.727 (95% CI 0.711 - 0.742) for the final model, AIC resulted in a significant reduction in deviance compared to the basic model, and the Hosmer-Lemeshow test showed no significant lack of fit (p = 0.07). The GeRi-Score predicted an in-house mortality of 5.3% vs. 5.3% observed mortality in the development dataset and 5.4% vs. 5.7% in the validation dataset. The GeRi-Score was able to distinguish between mild, moderate and high risk groups.
Conclusions: The GeRi-Score is an easy-to-use mortality-predicting tool with an acceptable discrimination and no significant lack of fit. The GeRi-Score might have the potential to distribute the intensity of perioperative medical care in hip fracture surgery and can be used in quality management programs as benchmark tool.
(© 2023. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)
Databáze: MEDLINE
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