Construction and validation of risk prediction model for postoperative complications in elderly patients with hip fractures and diabetes

XU Lingli; YING Zhihui; HU Haiou; HU Yaxi; LIU Qiang

doi:10.3969/j.issn.1671-315x.2025.09.006

Abstract：Objective To explore the influencing factors of postoperative complications in elderly patients with hip fractures with dia-betes,and to construct a risk prediction model.Methods A total of 360 elderly patients with hip fractures and diabetes admitted to a hospital from November 2019 to October 2022 were retrospectively selected as research subjects.They were divided into the modeling group(n=252)and the validation group(n=108)according to a ratio of 7∶3.Patients in the modeling group were divided into the normal group and the complication group based on whether complications occurred after the operation.Logistic regression analysis was used to analyze the influen-cing factors of postoperative complications in the patients of the modeling group and establish a risk prediction model.The receiver operating characteristic curve was used to evaluate the model.Additionally,108 elderly patients with hip fractures combined with diabetes in the valida-tion group were selected for external validation of the model.Results Among the 252 patients in the modeling group,97 cases had postopera-tive complications,with an incidence rate of 38.49%.Age,intraoperative blood loss,preoperative fasting blood glucose,albumin,and intraoper-ative blood glucose fluctuation were independent risk factors for postoperative complications in elderly patients with hip fractures combined with diabetes(P＜0.05).The results showed that the area under the receiver operating characteristic curve(AUC)in the modeling group was 0.918,the sensitivity was 0.804,and the specificity was 0.877.The AUC in the validation group was 0.932,the sensitivity was 0.773,and the specificity was 0.937.The calibration curve showed that there was good consistency between the predicted probability and the actual probabili-ty of the nomogram model.Conclusion The incidence of postoperative complications in elderly patients with hip fractures complicated with diabetes needs to be reduced.Age,intraoperative blood loss,preoperative fasting blood glucose,albumin,and intraoperative blood glucose fluc-tuation are closely related to the occurrence of postoperative complications.The risk prediction model constructed based on the above influen-cing factors has good predictive efficacy and can provide theoretical references for clinical diagnosis and treatment.