Development of a laboratory-based frailty index for risk prediction in elderly trauma patients with hip fractures

Abstract

This study aimed to develop a laboratory-based frailty index (FI-Lab) to predict 12-month mortality risk in elderly patients following a hip fracture (HF). A retrospective analysis of 235 consecutive patients over 70 years old, who underwent HF surgery, was conducted. The FI-Lab, based on 21 routine blood parameters, was evaluated using Receiver Operating Characteristics, Area Under the Curve (AUC), Kaplan-Meier curves, and Cox proportional Hazard ratios. The FI-Lab showed an AUC of 0.7177 for 6-month and 0.7423 for 1-year survival. High FI-Lab values correlated with higher preoperative ASA scores, longer time-to-surgery times, more perioperative transfusions, and higher postoperative complication rates. The Cox hazard ratio revealed a significant increase in the risk of death for 1 year and 6 months from a score of 0.4 and higher. These findings highlight the FI-Lab's clinical relevance and validity as a predictive tool, emphasizing the need for differentiated perioperative risk stratification.

Keywords: Hip fracture; Laboratory-based frailty index; Predictive tool.