Ryo Tanaka1, Takuya Umehara2, Takafumi Fujimura3, Junya Ozawa4. 1. Department of Rehabilitation, Hiroshima International University, Higashihiroshima, Japan. Electronic address: r-tanaka@hs.hirokoku-u.ac.jp. 2. Department of Rehabilitation, Saiseikaikure Hospital, Kure, Japan. 3. Department of Rehabilitation, Chūgokurōsai Hospital, Kure, Japan. 4. Department of Rehabilitation, Hiroshima International University, Higashihiroshima, Japan.
Abstract
OBJECTIVES: To develop and assess a clinical prediction rule (CPR) to predict declines in activities of daily living (ADL) at 6 months after surgery for hip fracture repair. DESIGN: Prospective, cohort study. SETTING: From hospital to home. PARTICIPANTS: Patients (N=104) with hip fractures after surgery. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: ADL were assessed using the Barthel Index at 6 months after surgery. RESULTS: At 6 months after surgery, 86 patients (82.6%) were known to be alive, 1 patient (1.0%) had died, and 17 (16.3%) were lost to follow-up. Thirty-two patients (37.2%) did not recover their ADL at 6 months after surgery to levels before fracture. The classification and regression trees methodology was used to develop 2 models to predict a decline in ADL: (1) model 1 included age, type of fracture, and care level before fracture (sensitivity=75.0%, specificity=81.5%, positive predictive value=70.6%, positive likelihood ratio=4.050); and (2) model 2 included the degree of independence 2 weeks postsurgery for ADL chair transfer, ADL ambulation, and age (sensitivity=65.6%, specificity=87.0%, positive predictive value=75.0%, positive likelihood ratio=5.063). The areas under the receiver operating characteristic curves of both CPR models were .825 (95% confidential interval, .728-.923) and .790 (95% confidence interval, .683-.897), respectively. CONCLUSIONS: CPRs with moderate accuracy were developed to predict declines in ADL at 6 months after surgery for hip fracture repair. Copyright Â
OBJECTIVES: To develop and assess a clinical prediction rule (CPR) to predict declines in activities of daily living (ADL) at 6 months after surgery for hip fracture repair. DESIGN: Prospective, cohort study. SETTING: From hospital to home. PARTICIPANTS: Patients (N=104) with hip fractures after surgery. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: ADL were assessed using the Barthel Index at 6 months after surgery. RESULTS: At 6 months after surgery, 86 patients (82.6%) were known to be alive, 1 patient (1.0%) had died, and 17 (16.3%) were lost to follow-up. Thirty-two patients (37.2%) did not recover their ADL at 6 months after surgery to levels before fracture. The classification and regression trees methodology was used to develop 2 models to predict a decline in ADL: (1) model 1 included age, type of fracture, and care level before fracture (sensitivity=75.0%, specificity=81.5%, positive predictive value=70.6%, positive likelihood ratio=4.050); and (2) model 2 included the degree of independence 2 weeks postsurgery for ADL chair transfer, ADL ambulation, and age (sensitivity=65.6%, specificity=87.0%, positive predictive value=75.0%, positive likelihood ratio=5.063). The areas under the receiver operating characteristic curves of both CPR models were .825 (95% confidential interval, .728-.923) and .790 (95% confidence interval, .683-.897), respectively. CONCLUSIONS: CPRs with moderate accuracy were developed to predict declines in ADL at 6 months after surgery for hip fracture repair. Copyright Â
Authors: Janusz Wojtusiak; Negin Asadzadehzanjani; Cari Levy; Farrokh Alemi; Allison E Williams Journal: BMC Med Inform Decis Mak Date: 2021-01-09 Impact factor: 2.796
Authors: Nath Adulkasem; Phichayut Phinyo; Jiraporn Khorana; Dumnoensun Pruksakorn; Theerachai Apivatthakakul Journal: Int J Environ Res Public Health Date: 2021-12-24 Impact factor: 3.390