Skip to main content
Erschienen in: Archives of Osteoporosis 1/2019

01.12.2019 | Original Article

Factors affecting recovery during the first 6 months after hip fracture, using the decision tree model

verfasst von: Najmeh Maharlouei, Fatemeh Jafarzadeh, Kamran B. Lankarani

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

Summary

Pelvic fractures are one of the most common orthopedic problems that can reduce the quality of life in the elderly. In this prospective study, we found that osteoporosis, depression, and socioeconomic status were the most important factors associated with patients’ recovery during the first 6 months after pelvic fracture.

Purpose

Hip fractures are one of the most common orthopedic problems that can reduce the quality of life in the elderly. Considering that, we aimed to provide a comprehensive assessment of the factors affecting recovery during the first 6 months after hip fracture.

Methods

All patients with hip fracture admitted to any of the orthopedic hospitals during July 10, 2011 to July 9, 2012 in Shiraz, Iran were included in this prospective cohort study. Patients’ demographic data and also information regarding their performance and mobility after hip fracture was collected in two interviews at intervals of 6 months. All analyses were done in R software and mostly by party packages and PCAmixdata package. Tree and forest models of conditional inference were used to evaluate the factors affecting the recovery after hip fracture.

Results

Two hundred sixty-six out of 514 patients (51.75%) with hip fracture recovered completely after a 6-month follow-up period. Osteoporosis, new-onset depression after hip fracture, and socioeconomic status (SES) were the most important predictors of patients’ mobility status 6 months after hip fracture. In identifying predictor variables, the conditional inference forest method provided a more appropriate fit for the data than the conditional inference tree.

Conclusions

Awareness of the factors that affect patients’ recovery can be helpful in improving the patients’ health, as well as improving care services, thereby increasing the success of treatment. Osteoporosis, new-onset depression after hip fracture, and SES were the most important factors associated with patients’ recovery. Therefore, focusing on these variables is essential.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Gialanella B, Prometti P, Monguzzi V, Ferlucci C, Baiardi P, Comini L (2018) Determinants of functional outcome in hip fracture: the role of comorbidity. Aging Clin Exp Res 30(6):643–650 Gialanella B, Prometti P, Monguzzi V, Ferlucci C, Baiardi P, Comini L (2018) Determinants of functional outcome in hip fracture: the role of comorbidity. Aging Clin Exp Res 30(6):643–650
2.
Zurück zum Zitat Castelli A, Daidone S, Jacobs R, Kasteridis P, Street AD (2015) The determinants of costs and length of stay for hip fracture patients. PLoS One 10(7):e0133545CrossRef Castelli A, Daidone S, Jacobs R, Kasteridis P, Street AD (2015) The determinants of costs and length of stay for hip fracture patients. PLoS One 10(7):e0133545CrossRef
3.
Zurück zum Zitat Rostagno C, Buzzi R, Campanacci D, Boccacini A, Cartei A, Virgili G, Belardinelli A, Matarrese D, Ungar A, Rafanelli M (2016) In hospital and 3-month mortality and functional recovery rate in patients treated for hip fracture by a multidisciplinary team. PLoS One 11(7):e0158607CrossRef Rostagno C, Buzzi R, Campanacci D, Boccacini A, Cartei A, Virgili G, Belardinelli A, Matarrese D, Ungar A, Rafanelli M (2016) In hospital and 3-month mortality and functional recovery rate in patients treated for hip fracture by a multidisciplinary team. PLoS One 11(7):e0158607CrossRef
4.
Zurück zum Zitat Sheikh HQ, Hossain FS, Aqil A, Akinbamijo B, Mushtaq V, Kapoor H (2017) A comprehensive analysis of the causes and predictors of 30-day mortality following hip fracture surgery. Clin Orthop Surg 9(1):10–18CrossRef Sheikh HQ, Hossain FS, Aqil A, Akinbamijo B, Mushtaq V, Kapoor H (2017) A comprehensive analysis of the causes and predictors of 30-day mortality following hip fracture surgery. Clin Orthop Surg 9(1):10–18CrossRef
5.
Zurück zum Zitat Ekegren C, Edwards E, Page R, Hau R, de Steiger R, Bucknill A, Liew S, Oppy A, Gabbe B (2016) Twelve-month mortality and functional outcomes in hip fracture patients under 65 years of age. Injury 47(10):2182–2188CrossRef Ekegren C, Edwards E, Page R, Hau R, de Steiger R, Bucknill A, Liew S, Oppy A, Gabbe B (2016) Twelve-month mortality and functional outcomes in hip fracture patients under 65 years of age. Injury 47(10):2182–2188CrossRef
6.
Zurück zum Zitat Ioannidis G, Jantzi M, Bucek J, Adachi JD, Giangregorio L, Hirdes J, Pickard L, Papaioannou A (2017) Development and validation of the Fracture Risk Scale (FRS) that predicts fracture over a 1-year time period in institutionalised frail older people living in Canada: an electronic record-linked longitudinal cohort study. BMJ Open 7(9):e016477CrossRef Ioannidis G, Jantzi M, Bucek J, Adachi JD, Giangregorio L, Hirdes J, Pickard L, Papaioannou A (2017) Development and validation of the Fracture Risk Scale (FRS) that predicts fracture over a 1-year time period in institutionalised frail older people living in Canada: an electronic record-linked longitudinal cohort study. BMJ Open 7(9):e016477CrossRef
7.
Zurück zum Zitat Maharlouei N, Khodayari M, Forouzan F, Rezaianzadeh A, Lankarani KB (2014) The incidence rate of hip fracture in Shiraz, Iran during 2008–2010. Arch Osteoporos 9(1):165CrossRef Maharlouei N, Khodayari M, Forouzan F, Rezaianzadeh A, Lankarani KB (2014) The incidence rate of hip fracture in Shiraz, Iran during 2008–2010. Arch Osteoporos 9(1):165CrossRef
8.
Zurück zum Zitat Lizaur-Utrilla A, Martinez-Mendez D, Collados-Maestre I, Miralles-Muñoz FA, Marco-Gomez L, Lopez-Prats FA (2016) Early surgery within 2 days for hip fracture is not reliable as healthcare quality indicator. Injury 47(7):1530–1535CrossRef Lizaur-Utrilla A, Martinez-Mendez D, Collados-Maestre I, Miralles-Muñoz FA, Marco-Gomez L, Lopez-Prats FA (2016) Early surgery within 2 days for hip fracture is not reliable as healthcare quality indicator. Injury 47(7):1530–1535CrossRef
9.
Zurück zum Zitat Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, Chrischilles EA, Pavlik CE, Wallace RB, Ohsfeldt RL (2009) The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol 170(10):1290–1299CrossRef Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, Chrischilles EA, Pavlik CE, Wallace RB, Ohsfeldt RL (2009) The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol 170(10):1290–1299CrossRef
10.
Zurück zum Zitat Folbert E, Hegeman J, Gierveld R, van Netten J, Van Der Velde D, Ten Duis H, Slaets J (2017) Complications during hospitalization and risk factors in elderly patients with hip fracture following integrated orthogeriatric treatment. Arch Orthop Trauma Surg 137(4):507–515CrossRef Folbert E, Hegeman J, Gierveld R, van Netten J, Van Der Velde D, Ten Duis H, Slaets J (2017) Complications during hospitalization and risk factors in elderly patients with hip fracture following integrated orthogeriatric treatment. Arch Orthop Trauma Surg 137(4):507–515CrossRef
11.
Zurück zum Zitat Mariconda M, Costa GG, Cerbasi S, Recano P, Orabona G, Gambacorta M, Misasi M (2016) Factors predicting mobility and the change in activities of daily living after hip fracture: a 1-year prospective cohort study. J Orthop Trauma 30(2):71–77CrossRef Mariconda M, Costa GG, Cerbasi S, Recano P, Orabona G, Gambacorta M, Misasi M (2016) Factors predicting mobility and the change in activities of daily living after hip fracture: a 1-year prospective cohort study. J Orthop Trauma 30(2):71–77CrossRef
12.
Zurück zum Zitat Maharlouei N, Atefi S, Namazi H, Kazemifar S, Soveid M, Shahraki H, Farahmand Z, Khodayari M, Arab P, Forouzan F (2017) The incidence of hip fracture in Shiraz, Iran: a promising rate comparing to previous studies. Osteoporos Int 28(6):1989–1993CrossRef Maharlouei N, Atefi S, Namazi H, Kazemifar S, Soveid M, Shahraki H, Farahmand Z, Khodayari M, Arab P, Forouzan F (2017) The incidence of hip fracture in Shiraz, Iran: a promising rate comparing to previous studies. Osteoporos Int 28(6):1989–1993CrossRef
13.
Zurück zum Zitat Moayyeri A, Soltani A, Larijani B, Naghavi M, Alaeddini F, Abolhassani F (2006) Epidemiology of hip fracture in Iran: results from the Iranian Multicenter Study on Accidental Injuries. Osteoporos Int 17(8):1252–1257CrossRef Moayyeri A, Soltani A, Larijani B, Naghavi M, Alaeddini F, Abolhassani F (2006) Epidemiology of hip fracture in Iran: results from the Iranian Multicenter Study on Accidental Injuries. Osteoporos Int 17(8):1252–1257CrossRef
14.
Zurück zum Zitat Hothorn T, Hornik K, Zeileis A (2006) Unbiased recursive partitioning: a conditional inference framework. J Comput Graph Stat 15(3):651–674CrossRef Hothorn T, Hornik K, Zeileis A (2006) Unbiased recursive partitioning: a conditional inference framework. J Comput Graph Stat 15(3):651–674CrossRef
15.
Zurück zum Zitat Strobl C, Boulesteix A-L, Zeileis A, Hothorn T (2007) Bias in random forest variable importance measures: illustrations, sources and a solution. BMC Bioinf 8(1):25CrossRef Strobl C, Boulesteix A-L, Zeileis A, Hothorn T (2007) Bias in random forest variable importance measures: illustrations, sources and a solution. BMC Bioinf 8(1):25CrossRef
16.
Zurück zum Zitat Garge NR, Bobashev GV, Eggleston B (2013) Random forest methodology for model-based recursive partitioning: the mobForest package for R. BMC Bioinf 14(1):125CrossRef Garge NR, Bobashev GV, Eggleston B (2013) Random forest methodology for model-based recursive partitioning: the mobForest package for R. BMC Bioinf 14(1):125CrossRef
17.
Zurück zum Zitat John Lu Z (2010) The elements of statistical learning: data mining, inference, and prediction. J R Stat Soc A Stat Soc 173(3):693–694CrossRef John Lu Z (2010) The elements of statistical learning: data mining, inference, and prediction. J R Stat Soc A Stat Soc 173(3):693–694CrossRef
18.
Zurück zum Zitat Chavent M, Kuentz-Simonet V, Labenne A, Saracco J (2014) Multivariate analysis of mixed data: the PCAmixdata R package. arXiv preprint arXiv:14114911 Chavent M, Kuentz-Simonet V, Labenne A, Saracco J (2014) Multivariate analysis of mixed data: the PCAmixdata R package. arXiv preprint arXiv:14114911
19.
Zurück zum Zitat Kettunen JA, Impivaara O, Kujala UM, Linna M, Mäki J, Räty H, Alanen E, Kaprio J, Videman T, Sarna S (2010) Hip fractures and femoral bone mineral density in male former elite athletes. Bone 46(2):330–335CrossRef Kettunen JA, Impivaara O, Kujala UM, Linna M, Mäki J, Räty H, Alanen E, Kaprio J, Videman T, Sarna S (2010) Hip fractures and femoral bone mineral density in male former elite athletes. Bone 46(2):330–335CrossRef
20.
Zurück zum Zitat Lenze EJ, Munin MC, Dew MA, Rogers JC, Seligman K, Mulsant BH, Reynolds CF (2004) Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture. Int J Geriatr Psychiatry 19(5):472–478CrossRef Lenze EJ, Munin MC, Dew MA, Rogers JC, Seligman K, Mulsant BH, Reynolds CF (2004) Adverse effects of depression and cognitive impairment on rehabilitation participation and recovery from hip fracture. Int J Geriatr Psychiatry 19(5):472–478CrossRef
21.
Zurück zum Zitat Mussolino ME (2005) Depression and hip fracture risk: the NHANES I epidemiologic follow-up study. Public Health Rep 120(1):71–75CrossRef Mussolino ME (2005) Depression and hip fracture risk: the NHANES I epidemiologic follow-up study. Public Health Rep 120(1):71–75CrossRef
22.
Zurück zum Zitat Zingmond D, Soohoo N, Silverman S (2006) The role of socioeconomic status on hip fracture. Osteoporos Int 17(10):1562–1568CrossRef Zingmond D, Soohoo N, Silverman S (2006) The role of socioeconomic status on hip fracture. Osteoporos Int 17(10):1562–1568CrossRef
23.
Zurück zum Zitat Farahmand BY, Persson P-G, Michaëlsson K, Baron JA, Parker M, Ljunghall S, Group SHFS (2000) Socioeconomic status, marital status and hip fracture risk: a population-based case–control study. Osteoporos Int 11(9):803–808CrossRef Farahmand BY, Persson P-G, Michaëlsson K, Baron JA, Parker M, Ljunghall S, Group SHFS (2000) Socioeconomic status, marital status and hip fracture risk: a population-based case–control study. Osteoporos Int 11(9):803–808CrossRef
24.
Zurück zum Zitat Shahnazari B, Keshtkar A, Soltani A, Aghamaleki A, Mansour A, Matin B, Saghafi S, Dini M, Khashayar P, Larijani B (2013) Estimating the avoidable burden of certain modifiable risk factors in osteoporotic hip fracture using Generalized Impact Fraction (GIF) model in Iran. J Diabetes Metab Disord 12(1):10CrossRef Shahnazari B, Keshtkar A, Soltani A, Aghamaleki A, Mansour A, Matin B, Saghafi S, Dini M, Khashayar P, Larijani B (2013) Estimating the avoidable burden of certain modifiable risk factors in osteoporotic hip fracture using Generalized Impact Fraction (GIF) model in Iran. J Diabetes Metab Disord 12(1):10CrossRef
Metadaten
Titel
Factors affecting recovery during the first 6 months after hip fracture, using the decision tree model
verfasst von
Najmeh Maharlouei
Fatemeh Jafarzadeh
Kamran B. Lankarani
Publikationsdatum
01.12.2019
Verlag
Springer London
Erschienen in
Archives of Osteoporosis / Ausgabe 1/2019
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-019-0611-4

Weitere Artikel der Ausgabe 1/2019

Archives of Osteoporosis 1/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.