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Abstract：
The aim of the current investigation was to compare the ability of several frailty scores to predict adverse outcomes in hip fracture patients. All adult patients (18 years or older) who suffered a hip fracture due to a fall and underwent surgical fixation were extracted from the 2019 National Inpatient Sample (NIS) Database. A combination of logistic regression and bootstrapping was used to compare the predictive ability of the Orthopedic Frailty Score (OFS), the Nottingham Hip Fracture Score (NHFS), the 11-factor modified Frailty Index (11-mFI) and 5-factor (5-mFI) modified Frailty Index, as well as the Johns Hopkins Frailty Indicator. A total of 227,850 patients were extracted from the NIS. In the prediction of in-hospital mortality and failure-to-rescue (FTR), the OFS surpassed all other frailty measures, approaching an acceptable predictive ability for mortality [AUC (95% CI): 0.69 (0.67-0.72)] and achieving an acceptable predictive ability for FTR [AUC (95% CI): 0.70 (0.67-0.72)]. The NHFS demonstrated the highest predictive ability for predicting any complication [AUC (95% CI): 0.62 (0.62-0.63)]. The 11-mFI exhibited the highest predictive ability for cardiovascular complications [AUC (95% CI): 0.66 (0.64-0.67)] and the NHFS achieved the highest predictive ability for delirium [AUC (95% CI): 0.69 (0.68-0.70)]. No score succeeded in effectively predicting venous thromboembolism or infections. In summary, the investigated frailty scores were most effective in predicting in-hospital mortality and failure-to-rescue; however, they struggled to predict complications.
摘要：
当前调查的目的是比较几种虚弱评分预测髋部骨折患者不良结局的能力。所有因跌倒而遭受髋部骨折并接受手术固定的成年患者（18岁或以上）均从2019年国家住院患者样本（NIS）数据库中提取。使用逻辑回归和自举相结合的方法来比较骨科脆弱评分（OFS）的预测能力，诺丁汉髋部骨折评分（NHFS），11因子修正脆弱指数(11-mFI)和5因子(5-mFI)修正脆弱指数，以及约翰·霍普金斯大学的脆弱指标。总共从NIS中提取了227,850名患者。在预测院内死亡率和抢救失败(FTR)时，OFS超越了所有其他脆弱的衡量标准，接近可接受的死亡率预测能力[AUC(95%CI):0.69(0.67-0.72)]和达到可接受的FTR预测能力[AUC(95%CI):0.70(0.67-0.72)].NHFS显示出预测任何并发症的最高预测能力[AUC(95%CI):0.62(0.62-0.63)]。11-mFI对心血管并发症的预测能力最高[AUC（95％CI）：0.66（0.64-0.67）]，NHFS对谵妄的预测能力最高[AUC（95％CI）：0.69（0.68-0.70）]。无评分可有效预测静脉血栓栓塞或感染。总之,调查的虚弱评分在预测住院死亡率和抢救失败方面最有效；然而，他们努力预测并发症。
