Prediction of 1-year post-operative mortality in elderly patients with fragility hip fractures in China: evaluation of risk prediction models.

This study systematically evaluates the predictive capacity of seven risk stratification models for 12-month postoperative mortality in geriatric patients with fragility hip fractures, while concurrently assessing their risk classification accuracy to inform perioperative protocol formulation, rehabilitation strategies, and prognostic management. Introduction: Current clinical practice lacks standardized criteria for mortality risk prediction in elderly fragility hip fracture patients. This investigation conducts a comparative evaluation of seven prognostic models-the Sernbo Score, Jiang et al. model, Nottingham Hip Fracture Score ( Methods: In this retrospective cohort analysis, all consecutive patients aged isk prediction in elderly fragility hip fracture between January 2018 and October 2022 were enrolled. Model-derived mortality predictions and risk categorizations were computed. Predictive performance was quantified through the predictive validity, the area under the receiver operating characteristic (ROC) curve (AUC) analysis, DeLong test, Hosmer-Lemeshow goodness-of-fit testing and calibration slope (95% CI), followed by precision assessment of risk stratification tiers. Results: The cohort demonstrated a 12-month mortality rate of 29.0%. Kaplan-Meier survival curves identified the first postoperative year as the highest mortality risk period. The ASAgeCoGeCC Score was the only model in this study that simultaneously demonstrated balanced sensitivity (0.73)/specificity (0.82), excellent discrimination (AUC = 0.84), and good calibration (H-L Conclusion: ASAgeCoGeCC score, NHFS and Holt et al.showed acceptable predictive performance, where the first two are applicable to clinical rapid decision-making, while NHFS has been extensively external validated. Holt et al.is more suitable for a well-resourced medical system. SHiPS displayed optimal risk categorization accuracy, suggesting potential for broader clinical implementation. These findings necessitate verification through prospective multi-center studies.