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      Early Detection of Pneumonia with the Help of Dementia in Geriatric Hip Fracture Patients

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          Abstract

          Objective

          To investigate the role of dementia in pneumonia among geriatric patients with hip fracture and further develop an algorithm for stratifying risk of developing postoperative pneumonia.

          Methods

          The algorithm was developed after retrospectively analyzing 1344 hip fracture patients in the National Clinical Research Center for Orthopedics, Sports Medicine, and Rehabilitation from 1992 to 2012. Twenty‐eight variables were analyzed for evaluating the ability to predict postoperative pneumonia. The validation of the algorithm was performed in the MIMIC‐III database after enrolling 235 patients.

          Results

          One thousand five hundred and seventy‐nine patients were enrolled, 4.69% patients had postoperative pneumonia in our hospital, and 17.02% suffered pneumonia in the MIMIC‐III database. Dementia patients had more postoperative pneumonia (12.68% vs 4.24%, P = 0.0075), as compared with patients without dementia. The algorithm included nine predictors: dementia, age, coronary heart disease, the American Society of Anesthesiologists score, surgical method, mechanical ventilation, anemia, hypoproteinemia, and high creatinine. Internal validation showed the algorithm with dementia could improve predictive performance, while external validation found the algorithm with or without dementia both had similar and good predictive ability.

          Conclusions

          The algorithm has the potential to be a pragmatic risk prediction tool to calculate risk of pneumonia in clinical practice and it may also be applicable in critically ill hip fracture patients with dementia.

          Abstract

          We developed an algorithm which has the potential to be a pragmatic risk prediction tool to calculate risk of pneumonia in clinical practice and it is also applicable in critically ill hip fracture patients with dementia. In the algorithm, there is a histogram plot of the number of patients against each score. The red line indicated that the number of patients with different scores was normally distributed. The yellow line meant that patients with higher scores had a higher risk of developing postoperative HAP. The dot showed the observed probabilities of postoperative HAP in each score.

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          Most cited references28

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          Regression Shrinkage and Selection Via the Lasso

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            Circulation, 101(23)
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              MIMIC-III, a freely accessible critical care database

              MIMIC-III (‘Medical Information Mart for Intensive Care’) is a large, single-center database comprising information relating to patients admitted to critical care units at a large tertiary care hospital. Data includes vital signs, medications, laboratory measurements, observations and notes charted by care providers, fluid balance, procedure codes, diagnostic codes, imaging reports, hospital length of stay, survival data, and more. The database supports applications including academic and industrial research, quality improvement initiatives, and higher education coursework.
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                Author and article information

                Contributors
                zdy8016@163.com
                825979020@qq.com
                Journal
                Orthop Surg
                Orthop Surg
                10.1111/(ISSN)1757-7861
                OS
                Orthopaedic Surgery
                John Wiley & Sons Australia, Ltd (Melbourne )
                1757-7853
                1757-7861
                12 January 2022
                January 2022
                : 14
                : 1 ( doiID: 10.1111/os.v14.1 )
                : 129-138
                Affiliations
                [ 1 ] Peking University People's Hospital Beijing China
                [ 2 ] The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, General Hospital of Chinese PLA Beijing China
                [ 3 ] Department of Orthopaedic Surgery Hainan Hospital of Chinese PLA General Hospital Beijing China
                [ 4 ] Chinese PLA Medical School Beijing China
                Author notes
                [*] [* ] Address for correspondence Dian‐ying Zhang, MD, Peking University People's Hospital, No.11 Xizhimen South Road, Xicheng District, Beijing, China 100044 Tel: +86‐010‐88326666; Fax: +86‐010‐88326666; Email: zdy8016@ 123456163.com ; Ming‐xing Lei, MD, The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, General Hospital of Chinese PLA, 28 Fuxing Road, Beijing, China 100853 Tel: +86‐010‐66938101; Fax: +86‐010‐68212342; Email: 825979020@ 123456qq.com

                Author information
                https://orcid.org/0000-0002-8588-679X
                Article
                OS13199
                10.1111/os.13199
                8755876
                35023317
                e08d4126-b1ad-442b-bb6f-4b179990748a
                © 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 16 December 2021
                : 09 July 2021
                : 19 December 2021
                Page count
                Figures: 6, Tables: 6, Pages: 10, Words: 6506
                Categories
                Clinical Article
                Clinical Articles
                Custom metadata
                2.0
                January 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.7.0 mode:remove_FC converted:12.01.2022

                dementia,geriatric hip fracture,pneumonia,prevention,risk algorithm

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