Abstract：
UNASSIGNED: Cemented hemiarthroplasty is an effective form of treatment for most patients with an intracapsular fracture of the hip. However, it remains unclear whether there are subgroups of patients who may benefit from the alternative operation of a modern uncemented hemiarthroplasty - the aim of this study was to investigate this issue. Knowledge about the heterogeneity of treatment effects is important for surgeons in order to target operations towards specific subgroups who would benefit the most.
UNASSIGNED: We used causal forest analysis to compare subgroup- and individual-level treatment effects between cemented and modern uncemented hemiarthroplasty in patients aged > 60 years with an intracapsular fracture of the hip, using data from the World Hip Trauma Evaluation 5 (WHiTE 5) multicentre randomized clinical trial. EuroQol five-dimension index scores were used to measure health-related quality of life at one, four, and 12 months postoperatively.
UNASSIGNED: Our analysis revealed a complex landscape of responses to the use of a cemented hemiarthroplasty in the 12 months after surgery. There was heterogeneity of effects with regard to baseline characteristics, including age, pre-injury health status, and lifestyle factors such as alcohol consumption. This heterogeneity was greater at the one-month mark than at subsequent follow-up timepoints, with particular regard to subgroups based on age. However, for all subgroups, the effect estimates for quality of life lay within the confidence intervals derived from the analysis of all patients.
UNASSIGNED: The use of a cemented hemiarthroplasty is expected to increase health-related quality of life compared with modern uncemented hemiarthroplasty for all subgroups of patients aged > 60 years with a displaced intracapsular fracture of the hip.
UNASSIGNED: We used causal forest analysis to compare subgroup- and individual-level treatment effects between cemented and modern uncemented hemiarthroplasty in patients aged > 60 years with an intracapsular fracture of the hip, using data from the World Hip Trauma Evaluation 5 (WHiTE 5) multicentre randomized clinical trial. EuroQol five-dimension index scores were used to measure health-related quality of life at one, four, and 12 months postoperatively.
UNASSIGNED: Our analysis revealed a complex landscape of responses to the use of a cemented hemiarthroplasty in the 12 months after surgery. There was heterogeneity of effects with regard to baseline characteristics, including age, pre-injury health status, and lifestyle factors such as alcohol consumption. This heterogeneity was greater at the one-month mark than at subsequent follow-up timepoints, with particular regard to subgroups based on age. However, for all subgroups, the effect estimates for quality of life lay within the confidence intervals derived from the analysis of all patients.
UNASSIGNED: The use of a cemented hemiarthroplasty is expected to increase health-related quality of life compared with modern uncemented hemiarthroplasty for all subgroups of patients aged > 60 years with a displaced intracapsular fracture of the hip.
摘要：
■对于大多数髋囊内骨折患者，骨水泥半髋关节置换术是一种有效的治疗方法。然而,目前尚不清楚是否有患者亚组可能从现代非骨水泥半髋关节置换术的替代手术中获益-这项研究的目的是调查这一问题.关于治疗效果的异质性的知识对于外科医生来说很重要，以便针对受益最大的特定亚组进行手术。
■我们使用因果森林分析来比较60岁以上髋关节囊内骨折患者的骨水泥和现代非骨水泥半髋关节置换术的亚组和个体水平治疗效果，使用来自世界髋关节创伤评估5（WHiTE5）多中心随机临床试验的数据。EuroQol五维指数得分用于衡量与健康相关的生活质量，四,术后12个月。
■我们的分析揭示了在手术后12个月内使用骨水泥半髋关节置换术的复杂反应。基线特征的影响存在异质性，包括年龄,伤前健康状况,和生活方式因素，如饮酒。这种异质性在一个月的时间点大于随后的随访时间点，特别是基于年龄的亚组。然而,对于所有子组，对生活质量的效应估计在对所有患者的分析得出的置信区间内.
■对于年龄>60岁的髋关节囊内移位骨折患者的所有亚组，与现代非骨水泥型半髋关节置换术相比，使用骨水泥型半髋关节置换术有望提高与健康相关的生活质量。
■我们使用因果森林分析来比较60岁以上髋关节囊内骨折患者的骨水泥和现代非骨水泥半髋关节置换术的亚组和个体水平治疗效果，使用来自世界髋关节创伤评估5（WHiTE5）多中心随机临床试验的数据。EuroQol五维指数得分用于衡量与健康相关的生活质量，四,术后12个月。
■我们的分析揭示了在手术后12个月内使用骨水泥半髋关节置换术的复杂反应。基线特征的影响存在异质性，包括年龄,伤前健康状况,和生活方式因素，如饮酒。这种异质性在一个月的时间点大于随后的随访时间点，特别是基于年龄的亚组。然而,对于所有子组，对生活质量的效应估计在对所有患者的分析得出的置信区间内.
■对于年龄>60岁的髋关节囊内移位骨折患者的所有亚组，与现代非骨水泥型半髋关节置换术相比，使用骨水泥型半髋关节置换术有望提高与健康相关的生活质量。
