Prognostic factors and prediction model for 1-year mortality after proximal humeral fracture
Summary The goal was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality after proximal humeral fracture (PHF). A clinical prediction model showed that the combination of 6 pre-fracture characteristics demonstrated good predictive properties for mortality...
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| Veröffentlicht in: | Archives of osteoporosis 2023-05, Vol.18 (1), p.76-76, Article 76 |
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| creator | Van Grootven, Bastiaan Janssens, Sigrid De Keyser, Laurence Voortmans, Jens Nijs, Stefaan Flamaing, Johan Dejaeger, Marian |
| description | Summary
The goal was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality after proximal humeral fracture (PHF). A clinical prediction model showed that the combination of 6 pre-fracture characteristics demonstrated good predictive properties for mortality within 1 year of PHF.
Introduction
Proximal humeral fractures (PFH) are the third most common major non-vertebral osteoporotic fractures in older persons and result in an increased mortality risk. The aim of this study was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality.
Methods
Retrospective study with 261 patients aged 65 and older who were treated for a PHF in University Hospitals Leuven between 2016 and 2018. Baseline variables including demographics, residential status, and comorbidities were collected. The primary outcome was 1-year mortality. A clinical prediction model was developed using LASSO regression and validated using split sample and bootstrapping methods. The discrimination and calibration were evaluated.
Results
Twenty-seven (10.3%) participants died within 1-year post-PHF. Pre-fracture independent ambulation (
p
|
| doi_str_mv | 10.1007/s11657-023-01260-8 |
| format | Article |
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The goal was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality after proximal humeral fracture (PHF). A clinical prediction model showed that the combination of 6 pre-fracture characteristics demonstrated good predictive properties for mortality within 1 year of PHF.
Introduction
Proximal humeral fractures (PFH) are the third most common major non-vertebral osteoporotic fractures in older persons and result in an increased mortality risk. The aim of this study was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality.
Methods
Retrospective study with 261 patients aged 65 and older who were treated for a PHF in University Hospitals Leuven between 2016 and 2018. Baseline variables including demographics, residential status, and comorbidities were collected. The primary outcome was 1-year mortality. A clinical prediction model was developed using LASSO regression and validated using split sample and bootstrapping methods. The discrimination and calibration were evaluated.
Results
Twenty-seven (10.3%) participants died within 1-year post-PHF. Pre-fracture independent ambulation (
p
< 0.001), living at home at time of fracture (
p
< 0.001), younger age (
p
= 0.006), higher BMI (
p
= 0.012), female gender (
p
= 0.014), and low number of comorbidities (
p
< 0.001) were predictors for 1-year survival. LASSO regression identified 6 stable predictors for a prediction model: age, gender, Charlson comorbidity score, BMI, cognitive impairment, and pre-fracture nursing home residency. The discrimination was 0.891 (95% CI, 0.833 to 0.949) in the training sample, 0.878 (0.792 to 0.963) in the validation sample and 0.756 (0.636 to 0.876) in the bootstrapping samples. A similar performance was observed for patients with and without surgery. The developed model demonstrated good calibration.
Conclusions
The combination of 6 pre-fracture characteristics demonstrated good predictive properties for mortality within 1 year of PHF. These findings can guide PHF treatment decisions.</description><identifier>ISSN: 1862-3514</identifier><identifier>EISSN: 1862-3514</identifier><identifier>DOI: 10.1007/s11657-023-01260-8</identifier><identifier>PMID: 37219703</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Aged ; Aged, 80 and over ; Calibration ; cognitive disorders ; comorbidity ; demographic statistics ; Endocrinology ; Female ; females ; Humans ; humeral fractures ; Medicine ; Medicine & Public Health ; Models, Statistical ; mortality ; Original Article ; Orthopedics ; patients ; Prognosis ; Retrospective Studies ; risk ; Shoulder Fractures ; surgery</subject><ispartof>Archives of osteoporosis, 2023-05, Vol.18 (1), p.76-76, Article 76</ispartof><rights>International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-debc736de550aaa58ba167a5fbed496d1f18e96946fc1729cef3433b8800d1943</citedby><cites>FETCH-LOGICAL-c380t-debc736de550aaa58ba167a5fbed496d1f18e96946fc1729cef3433b8800d1943</cites><orcidid>0000-0002-3182-573X ; 0000-0003-3749-5433 ; 0000-0002-1119-4918 ; 0000-0003-2652-2336 ; 0000-0002-7289-1397 ; 0000-0001-6789-1512</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11657-023-01260-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11657-023-01260-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37219703$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van Grootven, Bastiaan</creatorcontrib><creatorcontrib>Janssens, Sigrid</creatorcontrib><creatorcontrib>De Keyser, Laurence</creatorcontrib><creatorcontrib>Voortmans, Jens</creatorcontrib><creatorcontrib>Nijs, Stefaan</creatorcontrib><creatorcontrib>Flamaing, Johan</creatorcontrib><creatorcontrib>Dejaeger, Marian</creatorcontrib><title>Prognostic factors and prediction model for 1-year mortality after proximal humeral fracture</title><title>Archives of osteoporosis</title><addtitle>Arch Osteoporos</addtitle><addtitle>Arch Osteoporos</addtitle><description>Summary
The goal was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality after proximal humeral fracture (PHF). A clinical prediction model showed that the combination of 6 pre-fracture characteristics demonstrated good predictive properties for mortality within 1 year of PHF.
Introduction
Proximal humeral fractures (PFH) are the third most common major non-vertebral osteoporotic fractures in older persons and result in an increased mortality risk. The aim of this study was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality.
Methods
Retrospective study with 261 patients aged 65 and older who were treated for a PHF in University Hospitals Leuven between 2016 and 2018. Baseline variables including demographics, residential status, and comorbidities were collected. The primary outcome was 1-year mortality. A clinical prediction model was developed using LASSO regression and validated using split sample and bootstrapping methods. The discrimination and calibration were evaluated.
Results
Twenty-seven (10.3%) participants died within 1-year post-PHF. Pre-fracture independent ambulation (
p
< 0.001), living at home at time of fracture (
p
< 0.001), younger age (
p
= 0.006), higher BMI (
p
= 0.012), female gender (
p
= 0.014), and low number of comorbidities (
p
< 0.001) were predictors for 1-year survival. LASSO regression identified 6 stable predictors for a prediction model: age, gender, Charlson comorbidity score, BMI, cognitive impairment, and pre-fracture nursing home residency. The discrimination was 0.891 (95% CI, 0.833 to 0.949) in the training sample, 0.878 (0.792 to 0.963) in the validation sample and 0.756 (0.636 to 0.876) in the bootstrapping samples. A similar performance was observed for patients with and without surgery. The developed model demonstrated good calibration.
Conclusions
The combination of 6 pre-fracture characteristics demonstrated good predictive properties for mortality within 1 year of PHF. These findings can guide PHF treatment decisions.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Calibration</subject><subject>cognitive disorders</subject><subject>comorbidity</subject><subject>demographic statistics</subject><subject>Endocrinology</subject><subject>Female</subject><subject>females</subject><subject>Humans</subject><subject>humeral fractures</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Models, Statistical</subject><subject>mortality</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>patients</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>risk</subject><subject>Shoulder Fractures</subject><subject>surgery</subject><issn>1862-3514</issn><issn>1862-3514</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU9LxDAQxYMouq5-AQ_So5dqpmnS9CiL_2BBD3oTQppMtNI2a9KC--2NroonhcCEyW8ek_cIOQJ6CpRWZxFA8CqnBcspFILmcovMQIoiZxzK7V_3PbIf4wulggIXu2SPVQXUFWUz8ngX_NPg49iazGkz-hAzPdhsFdC2Zmz9kPXeYpc5HzLI16hDaoRRd-24zrQbMSTWv7W97rLnqceQqgtJaQp4QHac7iIeftU5ebi8uF9c58vbq5vF-TI3TNIxt9iYigmLnFOtNZeNBlFp7hq0ZS0sOJBYi7oUzkBV1AYdKxlrpKTUQl2yOTnZ6KZNXieMo-rbaLDr9IB-iooBT4cXvPoXLSRIymUp64QWG9QEH2NAp1YhfTOsFVD1EYDaBKBSAOozACXT0PGX_tT0aH9Gvh1PANsAMT0NTxjUi5_CkOz5S_YdRnaRmQ</recordid><startdate>20230523</startdate><enddate>20230523</enddate><creator>Van Grootven, Bastiaan</creator><creator>Janssens, Sigrid</creator><creator>De Keyser, Laurence</creator><creator>Voortmans, Jens</creator><creator>Nijs, Stefaan</creator><creator>Flamaing, Johan</creator><creator>Dejaeger, Marian</creator><general>Springer London</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope><orcidid>https://orcid.org/0000-0002-3182-573X</orcidid><orcidid>https://orcid.org/0000-0003-3749-5433</orcidid><orcidid>https://orcid.org/0000-0002-1119-4918</orcidid><orcidid>https://orcid.org/0000-0003-2652-2336</orcidid><orcidid>https://orcid.org/0000-0002-7289-1397</orcidid><orcidid>https://orcid.org/0000-0001-6789-1512</orcidid></search><sort><creationdate>20230523</creationdate><title>Prognostic factors and prediction model for 1-year mortality after proximal humeral fracture</title><author>Van Grootven, Bastiaan ; Janssens, Sigrid ; De Keyser, Laurence ; Voortmans, Jens ; Nijs, Stefaan ; Flamaing, Johan ; Dejaeger, Marian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-debc736de550aaa58ba167a5fbed496d1f18e96946fc1729cef3433b8800d1943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Calibration</topic><topic>cognitive disorders</topic><topic>comorbidity</topic><topic>demographic statistics</topic><topic>Endocrinology</topic><topic>Female</topic><topic>females</topic><topic>Humans</topic><topic>humeral fractures</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Models, Statistical</topic><topic>mortality</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>patients</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>risk</topic><topic>Shoulder Fractures</topic><topic>surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van Grootven, Bastiaan</creatorcontrib><creatorcontrib>Janssens, Sigrid</creatorcontrib><creatorcontrib>De Keyser, Laurence</creatorcontrib><creatorcontrib>Voortmans, Jens</creatorcontrib><creatorcontrib>Nijs, Stefaan</creatorcontrib><creatorcontrib>Flamaing, Johan</creatorcontrib><creatorcontrib>Dejaeger, Marian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>AGRICOLA</collection><collection>AGRICOLA - Academic</collection><jtitle>Archives of osteoporosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van Grootven, Bastiaan</au><au>Janssens, Sigrid</au><au>De Keyser, Laurence</au><au>Voortmans, Jens</au><au>Nijs, Stefaan</au><au>Flamaing, Johan</au><au>Dejaeger, Marian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic factors and prediction model for 1-year mortality after proximal humeral fracture</atitle><jtitle>Archives of osteoporosis</jtitle><stitle>Arch Osteoporos</stitle><addtitle>Arch Osteoporos</addtitle><date>2023-05-23</date><risdate>2023</risdate><volume>18</volume><issue>1</issue><spage>76</spage><epage>76</epage><pages>76-76</pages><artnum>76</artnum><issn>1862-3514</issn><eissn>1862-3514</eissn><abstract>Summary
The goal was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality after proximal humeral fracture (PHF). A clinical prediction model showed that the combination of 6 pre-fracture characteristics demonstrated good predictive properties for mortality within 1 year of PHF.
Introduction
Proximal humeral fractures (PFH) are the third most common major non-vertebral osteoporotic fractures in older persons and result in an increased mortality risk. The aim of this study was to investigate if patient characteristics can be used to predict 1-year post-fracture mortality.
Methods
Retrospective study with 261 patients aged 65 and older who were treated for a PHF in University Hospitals Leuven between 2016 and 2018. Baseline variables including demographics, residential status, and comorbidities were collected. The primary outcome was 1-year mortality. A clinical prediction model was developed using LASSO regression and validated using split sample and bootstrapping methods. The discrimination and calibration were evaluated.
Results
Twenty-seven (10.3%) participants died within 1-year post-PHF. Pre-fracture independent ambulation (
p
< 0.001), living at home at time of fracture (
p
< 0.001), younger age (
p
= 0.006), higher BMI (
p
= 0.012), female gender (
p
= 0.014), and low number of comorbidities (
p
< 0.001) were predictors for 1-year survival. LASSO regression identified 6 stable predictors for a prediction model: age, gender, Charlson comorbidity score, BMI, cognitive impairment, and pre-fracture nursing home residency. The discrimination was 0.891 (95% CI, 0.833 to 0.949) in the training sample, 0.878 (0.792 to 0.963) in the validation sample and 0.756 (0.636 to 0.876) in the bootstrapping samples. A similar performance was observed for patients with and without surgery. The developed model demonstrated good calibration.
Conclusions
The combination of 6 pre-fracture characteristics demonstrated good predictive properties for mortality within 1 year of PHF. These findings can guide PHF treatment decisions.</abstract><cop>London</cop><pub>Springer London</pub><pmid>37219703</pmid><doi>10.1007/s11657-023-01260-8</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-3182-573X</orcidid><orcidid>https://orcid.org/0000-0003-3749-5433</orcidid><orcidid>https://orcid.org/0000-0002-1119-4918</orcidid><orcidid>https://orcid.org/0000-0003-2652-2336</orcidid><orcidid>https://orcid.org/0000-0002-7289-1397</orcidid><orcidid>https://orcid.org/0000-0001-6789-1512</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Calibration cognitive disorders comorbidity demographic statistics Endocrinology Female females Humans humeral fractures Medicine Medicine & Public Health Models, Statistical mortality Original Article Orthopedics patients Prognosis Retrospective Studies risk Shoulder Fractures surgery |
| title | Prognostic factors and prediction model for 1-year mortality after proximal humeral fracture |
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