Prediction of postoperative mortality in elderly patient with hip fractures: a single-centre, retrospective cohort study

Romain Niessen, Benoit Bihin, Maximilien Gourdin, Jean-Cyr Yombi, Olivier Cornu, Patrice Forget

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Elderly patients are at high risk for postoperative complications and increased mortality after hip fracture (HF) surgery due to frailty and co-morbidities. The prediction of postoperative outcome could be used for clinical decision making. A reliable score to predict postoperative mortality after HF surgery in this sub-population remains unavailable.

METHODS: A single-centre retrospective cohort study was performed in 782 patients who were operated on for HF. Receiver Operating Characteristic (ROC)-curves were used to analyse the performance of gender, age, neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) at admission (D0) as prognostic factors, alone or combined with the PreOperative Score to predict PostOperative Mortality (POSPOM) in univariate and multivariate linear regression models.

RESULTS: No correlation between gender, age, NLR D0 or CRP D0 and postoperative, intra-hospital mortality was found. The Area Under the ROC-curve (AUC) for age, male gender, NLR and CRP were 0.61 [95% confidence interval (CI) = 0.45-0.61], 0.56 [95% CI = 0.42-0.56], 0.47 [95% CI = 0.29-0.47] and 0.49 [95% CI = 0.31-0.49] respectively. Combination with the POSPOM score did not increase its discriminative capacity as neither age (AUC = 0.69, 95% CI = 0.54-0.69), gender (AUC = 0.72, 95% CI = 0.58-0.72), NLR D0 (AUC = 0.71, 95% CI = 0.56-0.71), nor the CRP D0 (AUC = 0.71, 95% CI = 0.58-0.71) improved the POSPOM performance.

CONCLUSIONS: Neither age, gender, NLR D0 nor CRP D0 are suitable parameters to predict postoperative, intra-hospital mortality in elderly patients undergoing surgery for HF.

Original languageEnglish
Pages (from-to)183
JournalAnesthesiology
Volume18
Issue number1
DOIs
Publication statusPublished - 2018
Externally publishedYes

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Hip Fractures
Cohort Studies
Retrospective Studies
ROC Curve
Confidence Intervals
C-Reactive Protein
Mortality
Neutrophils
Area Under Curve
Lymphocytes
Hospital Mortality
Linear Models
Morbidity
Population

Cite this

@article{a5c0306e8520480694c6b350b4eda47d,
title = "Prediction of postoperative mortality in elderly patient with hip fractures: a single-centre, retrospective cohort study",
abstract = "BACKGROUND: Elderly patients are at high risk for postoperative complications and increased mortality after hip fracture (HF) surgery due to frailty and co-morbidities. The prediction of postoperative outcome could be used for clinical decision making. A reliable score to predict postoperative mortality after HF surgery in this sub-population remains unavailable.METHODS: A single-centre retrospective cohort study was performed in 782 patients who were operated on for HF. Receiver Operating Characteristic (ROC)-curves were used to analyse the performance of gender, age, neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) at admission (D0) as prognostic factors, alone or combined with the PreOperative Score to predict PostOperative Mortality (POSPOM) in univariate and multivariate linear regression models.RESULTS: No correlation between gender, age, NLR D0 or CRP D0 and postoperative, intra-hospital mortality was found. The Area Under the ROC-curve (AUC) for age, male gender, NLR and CRP were 0.61 [95{\%} confidence interval (CI) = 0.45-0.61], 0.56 [95{\%} CI = 0.42-0.56], 0.47 [95{\%} CI = 0.29-0.47] and 0.49 [95{\%} CI = 0.31-0.49] respectively. Combination with the POSPOM score did not increase its discriminative capacity as neither age (AUC = 0.69, 95{\%} CI = 0.54-0.69), gender (AUC = 0.72, 95{\%} CI = 0.58-0.72), NLR D0 (AUC = 0.71, 95{\%} CI = 0.56-0.71), nor the CRP D0 (AUC = 0.71, 95{\%} CI = 0.58-0.71) improved the POSPOM performance.CONCLUSIONS: Neither age, gender, NLR D0 nor CRP D0 are suitable parameters to predict postoperative, intra-hospital mortality in elderly patients undergoing surgery for HF.",
author = "Romain Niessen and Benoit Bihin and Maximilien Gourdin and Jean-Cyr Yombi and Olivier Cornu and Patrice Forget",
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Prediction of postoperative mortality in elderly patient with hip fractures : a single-centre, retrospective cohort study. / Niessen, Romain; Bihin, Benoit; Gourdin, Maximilien; Yombi, Jean-Cyr; Cornu, Olivier; Forget, Patrice.

In: Anesthesiology, Vol. 18, No. 1, 2018, p. 183.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prediction of postoperative mortality in elderly patient with hip fractures

T2 - a single-centre, retrospective cohort study

AU - Niessen, Romain

AU - Bihin, Benoit

AU - Gourdin, Maximilien

AU - Yombi, Jean-Cyr

AU - Cornu, Olivier

AU - Forget, Patrice

PY - 2018

Y1 - 2018

N2 - BACKGROUND: Elderly patients are at high risk for postoperative complications and increased mortality after hip fracture (HF) surgery due to frailty and co-morbidities. The prediction of postoperative outcome could be used for clinical decision making. A reliable score to predict postoperative mortality after HF surgery in this sub-population remains unavailable.METHODS: A single-centre retrospective cohort study was performed in 782 patients who were operated on for HF. Receiver Operating Characteristic (ROC)-curves were used to analyse the performance of gender, age, neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) at admission (D0) as prognostic factors, alone or combined with the PreOperative Score to predict PostOperative Mortality (POSPOM) in univariate and multivariate linear regression models.RESULTS: No correlation between gender, age, NLR D0 or CRP D0 and postoperative, intra-hospital mortality was found. The Area Under the ROC-curve (AUC) for age, male gender, NLR and CRP were 0.61 [95% confidence interval (CI) = 0.45-0.61], 0.56 [95% CI = 0.42-0.56], 0.47 [95% CI = 0.29-0.47] and 0.49 [95% CI = 0.31-0.49] respectively. Combination with the POSPOM score did not increase its discriminative capacity as neither age (AUC = 0.69, 95% CI = 0.54-0.69), gender (AUC = 0.72, 95% CI = 0.58-0.72), NLR D0 (AUC = 0.71, 95% CI = 0.56-0.71), nor the CRP D0 (AUC = 0.71, 95% CI = 0.58-0.71) improved the POSPOM performance.CONCLUSIONS: Neither age, gender, NLR D0 nor CRP D0 are suitable parameters to predict postoperative, intra-hospital mortality in elderly patients undergoing surgery for HF.

AB - BACKGROUND: Elderly patients are at high risk for postoperative complications and increased mortality after hip fracture (HF) surgery due to frailty and co-morbidities. The prediction of postoperative outcome could be used for clinical decision making. A reliable score to predict postoperative mortality after HF surgery in this sub-population remains unavailable.METHODS: A single-centre retrospective cohort study was performed in 782 patients who were operated on for HF. Receiver Operating Characteristic (ROC)-curves were used to analyse the performance of gender, age, neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) at admission (D0) as prognostic factors, alone or combined with the PreOperative Score to predict PostOperative Mortality (POSPOM) in univariate and multivariate linear regression models.RESULTS: No correlation between gender, age, NLR D0 or CRP D0 and postoperative, intra-hospital mortality was found. The Area Under the ROC-curve (AUC) for age, male gender, NLR and CRP were 0.61 [95% confidence interval (CI) = 0.45-0.61], 0.56 [95% CI = 0.42-0.56], 0.47 [95% CI = 0.29-0.47] and 0.49 [95% CI = 0.31-0.49] respectively. Combination with the POSPOM score did not increase its discriminative capacity as neither age (AUC = 0.69, 95% CI = 0.54-0.69), gender (AUC = 0.72, 95% CI = 0.58-0.72), NLR D0 (AUC = 0.71, 95% CI = 0.56-0.71), nor the CRP D0 (AUC = 0.71, 95% CI = 0.58-0.71) improved the POSPOM performance.CONCLUSIONS: Neither age, gender, NLR D0 nor CRP D0 are suitable parameters to predict postoperative, intra-hospital mortality in elderly patients undergoing surgery for HF.

U2 - 10.1186/s12871-018-0646-x

DO - 10.1186/s12871-018-0646-x

M3 - Article

C2 - 30509182

VL - 18

SP - 183

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

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