Development and Internal Validation of a Prediction Model for In-Hospital Mortality in Geriatric Patients With a Hip Fracture

Objective: To develop and validate a prediction model for in-hospital mortality in patients with hip fracture 85 years of age or older undergoing surgery.

Design: A multicenter prospective cohort study.

Setting: Six Dutch trauma centers, level 2 and 3.

Participants: Patients with hip fracture 85 years of age or older undergoing surgery.

Intervention: Hip fracture surgery.

Main outcome measurements: In-hospital mortality.

Results: The development cohort consisted of 1014 patients. In-hospital mortality was 4%. Age, male sex, American Society of Anesthesiologists classification, and hemoglobin levels at presentation were independent predictors of in-hospital mortality. The bootstrap adjusted performance showed good discrimination with a c-statistic of 0.77.

Conclusion: Age, male sex, higher American Society of Anesthesiologists classification, and lower hemoglobin levels at presentation are robust independent predictors of in-hospital mortality in patients with geriatric hip fracture and were incorporated in a simple prediction model with good accuracy and no lack of fit.

Level of evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.