Risk Factors for Acute Heart Failure in Older Adults with Hip Fractures After Surgery and Construction of a Nomogram Predictive Model.

Purpose: The frequency of acute heart failure (AHF) is relatively high in older adults undergoing hip fracture surgery. This study aims to explore the possible risk factors and create a nomogram predictive model for quantifying the level of risk. Patients and Methods: This study retrospectively analyzed older adults who underwent hip fracture surgery at the Orthopaedic Department of Chengdu Fifth People's Hospital affiliated with Chengdu University of Traditional Chinese Medicine between January 2022 and December 2023. Statistical analysis was performed using SPSS 25.0 and R software to develop a nomogram prediction model. The model's predictive precision was evaluated by examining the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Calibration curves and decision curve analysis (DCA) were also utilized to assess the model's calibration and clinical utility comprehensively. Results: This study underwent rigorous screening and ultimately included 313 patients. These samples were then divided into two groups in a 7:3 ratio, with 220 cases serving as the training set and 93 cases serving as the validation set. After performing univariate analysis and multivariate logistic regression analysis, we developed a nomogram based on the training set model, with an AUC of 0.861 (95% CI: 0.796-0.925). In the validation set model, the AUC was 0.819 (95% CI: 0.692-0.946). According to the calibration curve, the model shows a good fit. The DCA results suggest that the model holds significant practical value. Conclusion: Statistical data indicates that the incidence of AHF post-operative in older adults with hip fractures reaches up to 15.34%. Multiple regression analysis revealed that age, cerebrovascular disease, cirrhosis, malnutrition, intraoperative blood loss, and hypoproteinemia are significant risk factors. Based on these findings, this study developed a nomogram prediction model to accurately assess the risk of AHF following surgery in older adults with hip fractures.