Predictive Model of Recovery to Prefracture Activities-of-Daily-Living Status One Year after Fragility Hip Fracture
Issued Date
2024-04-01
Resource Type
ISSN
1010660X
eISSN
16489144
Scopus ID
2-s2.0-85191302424
Pubmed ID
38674261
Journal Title
Medicina (Lithuania)
Volume
60
Issue
4
Rights Holder(s)
SCOPUS
Bibliographic Citation
Medicina (Lithuania) Vol.60 No.4 (2024)
Suggested Citation
Kitcharanant N., Atthakomol P., Khorana J., Phinyo P., Unnanuntana A. Predictive Model of Recovery to Prefracture Activities-of-Daily-Living Status One Year after Fragility Hip Fracture. Medicina (Lithuania) Vol.60 No.4 (2024). doi:10.3390/medicina60040615 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98216
Title
Predictive Model of Recovery to Prefracture Activities-of-Daily-Living Status One Year after Fragility Hip Fracture
Author's Affiliation
Corresponding Author(s)
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Abstract
Background and Objectives: Achieving prefracture functional status is a critical objective following a hip fracture, yet fewer than half of patients reach this milestone. The adoption of tools for assessing functional outcomes is increasingly recognized as essential for evaluating recovery following treatment for fragility hip fractures. We developed multivariable clinical prediction criteria to estimate the likelihood of patients regaining their prefracture activities-of-daily-living (ADL) status one year after sustaining a fragility hip fracture. Materials and Methods: A retrospective cohort of patients treated for fragility hip fractures at a university-affiliated tertiary care center between February 2017 and April 2019 served as the basis for developing and internally validating the clinical prediction criteria. We applied a multivariable fractional polynomial method to integrate several continuous predictors into a binary logistic regression model. Results: The study included 421 patients, 324 (77%) of whom reported regaining their prefracture activities-of-daily-living level one year after experiencing fragility hip fractures. Significant predictors, such as the prefracture Barthel index, EQ-VAS score, and treatment modality, were incorporated into the predictive model. The model demonstrated excellent discriminative power (AuROC of 0.86 [95% CI 0.82–0.91]) and satisfactory calibration. Conclusions: The predictive model has significant discriminative ability with good calibration and provides clinicians with a means to forecast the recovery trajectories of individual patients one year after a fragility hip fracture, which could be useful because prompt clinical decision-making is aided by this information. Patients and caregivers can also be counseled and encouraged to follow up with the medical activities and interventions deemed essential by doctors who used the prediction tool. Access to the model is provided through a web application. External validation is warranted in order to prove its applicability and generalizability.