ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1515557
This article is part of the Research TopicNew Advances in Perioperative Management of Hip FractureView all 5 articles
Clinical prediction model and 2-year mortality for multiple organ dysfunction in patients aged 80 years or older following hip fracture surgery: A prospective cohort study
Provisionally accepted
- 1Hospital infection management department, Sichuan Provincial Orthopedics Hospital, Chengdu, China
- 2Intensive Care Unit, Sichuan Provincial Orthopedics Hospital, Chengdu, China
- 3Anesthesiology department, Sichuan Provincial Orthopedics Hospital, Chengdu, China
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The prediction of postoperative complications is vital in the management of hip fracture. This study specifically examined the occurrence of multiple organ dysfunction syndrome in the elderly (MODSE) following hip fracture surgery and explored its predictive model and correlation with long-term mortality.Methods: This prospective cohort study included all patients aged 80 years and older who underwent hip fracture surgery at a tertiary orthopedic hospital between January 2020 and March 2021. The patients were categorized into the MODSE and non-MODSE groups. The pre, peri, and postoperative variables were retrospectively screened to establish and validate prediction model for MODSE. The patients were subsequently followed up prospectively until 2 years after discharge in order to explore the association between MODSE and long-term mortality.Results: Significant discrepancies in clinical characteristics were observed between MODSE and non-MODSE patients. Those with a preoperative age-adjusted Charlson Comorbidity Index > 5, Impaired swallowing, an Acute Physiology and Chronic Health Evaluation II score ≥ 12 within the initial 24 hours post-surgery, prothrombin time > 14 seconds, along with high-sensitivity cardiac troponin T > 14 pg/mL and procalcitonin levels > 0.25 ng/mL on the first day after surgery were found to have a higher 3 likelihood of developing MODSE. Moreover, the presence of MODSE correlated with a 3.13-fold and 2.88-fold increased risk of mortality at 1 and 2 years post-discharge, respectively.Predicting postoperative MODSE in elderly hip fracture patients is essential and feasible, as its occurrence represents poor outcome during hospitalization and predicts heightened long-term mortality rates.
Keywords: Lei Liu (0000-0002-8717-7364), Yang Deng Elderly, Hip fracture surgery, multiple organ dysfunction syndrome, Mortality, Prediction model
Received: 23 Oct 2024; Accepted: 07 Jul 2025.
Copyright: © 2025 Liu, Deng, Qin, Zhang, Yang, Feng and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhijun Qin, Anesthesiology department, Sichuan Provincial Orthopedics Hospital, Chengdu, China
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