Characteristics of Postoperative Heart Failure in Older Hip Fractures Patients Combined with Coronary Heart Disease and Construction of a Prediction Model of Nomogram, a Retrospective Cohort Study

Figures & data

Table 1 The Demographic and Clinical Characteristics of Older Patients with or without Acute Heart Failure (AHF)

Variable	Total	AHF (n)	Non-AHF (n)	P(value)
Gender n(%)
Male	353(43.7%)	144(17.8%)	191(23.6%)	0.943
Female	473 (56.3%)	202(25.0%)	271(33.6%)
Age(years)	79.21	81.52	77.48	0.000*
Type of fracture n(%)
Femoral neck fracture	371(45.9%)	135(16.7%)	236(29.2%)	0.001*
Intertrochanteric fracture	437(54.1%)	211(26.1%)	226(28.0%)
History of CHD
Antiplatelet or Anticoagulants drugs	252(31.2%)	104(12.9%)	148(18.3%)	0.225
Revascularization	69(8.5%)	31(3.8%)	38(4.7%)	0.245
left ventricular ejection fraction	61.83%	61.30%	62.3%	0.735
Injury mechanism n(%)
Accidently Falling	633(78.3%)	288(35.6%)	345(42.7%)	0.736
Car accident	90(11.2%)	34(4.2%)	56(6.9%)	0.425
Dizziness and falling	85(10.5%)	24(3.0%)	61(7.5%)	0.093
Comorbidity n(%)
Hypertension	495(61.3%)	222(27.5%)	273(33.8%)	0.143
Diabetes	330(40.8%)	147(18.2%)	183(22.6%)	0.411
Old cerebral infarction	348(43.1%)	159(19.7%)	189(23.4%)	0.152
Osteoporosis	138(17.1%)	67(8.3%)	71(8.8%)	0.243
COPD	182(22.5%)	119(14.7%)	63(7.8%)	0.000*
Carotid plaque	149(18.4%)	67(8.3%)	82(10.1%)	0.558
Coronary calcification	254(31.4%)	122(15.1%)	132(16.3%)	0.043*
Chronic kidney disease	37(4.6%)	23(2.8%)	14(1.7%)	0.015*
Liver disease	54(6.7%)	30(3.7%)	24(3.0%)	0.052
Preoperative waiting	520(64.4%)	259(32.1%)	261(32.3%)	0.000*
Time>3(days)	104.47	99.62	108.10	0.000*
Hemoglobin at admission(g/L)	59(7.3%)	45(5.6%)	14(1.7%)	0.000
ASA≥3 at admission n(%)	375(46.4%)	184(22.8%)	191(23.6%)	0.001*
Anemia at admission	240(29.7%)	118(14.6%)	122(15.1%)	0.018*
Hypoproteinemia at admission n(%)
Albumin at admission(g/L)	32.13	31.68	32.47	0.007*
Intraoperative bleeding(mL)	211.31	212.63	210.32	0.815
Operation time(days)	2.2±0.3	2.3±0.2	2.0±0.4	0.557
Type of anesthetic
General anesthetic	543(67.2%)	219(27.1%)	324(40.1%)	0.005*
Regional anesthesia	265(32.8%)	132(16.3%)	133(16.5%)
Preoperative atrial fibrillation	99(12.3%)	48(5.9%)	51(6.3%)	0.063

Notes: Values are presented as mean ± standard deviation, median (interquartile range), or number (percentage) as appropriate SD Standard deviation. “*” means P<0.05.

Abbreviation: COPD, chronic obstructive pulmonary disease.

Figure 1 The flowchart of our research.

Table 2 Univariate and Multivariate Logistic Regression Analysis of Risk Factors for Acute Heart Failure in Training Set

	Univariate Analysis			Multivariate Analysis
	OR	95%CL	P	OR	95%CL	P
Type of fractures
Femoral neck fracture	1.632	1.230–2.165	0.001*	1.641	1.189–2.265	0.003*
Intertrochanteric fracture
Age	1.115	1.087–1.143	0.000*	1.107	1.077–1.137	0.000*
Coronary calcification	1.362	1.010–1.836	0.043*	0.883	0.610–1.278	0.510
ASA≥3	4.787	2.580–8.869	0.000*	3.055	1.423–6.560	0.004*
Chronic kidney disease	2.279	1.155–4.496	0.018*	1.135	0.499–2.581	0.762
COPD	2.388	1.788–3.188	0.000*	2.149	1.419–3.256	0.000*
Anemia at admission	0.959	0.950–0.969	0.000*	0.962	0.951–0.973	0.000*
Hypoproteinemia	1.442	1.065–1.954	0.018*	1.300	0.916–1.844	0.142
Surgery waiting time>3(days)	2.293	1.691–3.109	0.000*	2.014	1.430--2.836	0.000*
Type of anesthesia
General anesthesia	0.655	0.487–0.881-	0.005*	1.121	0.777–1.617	0.542
Regional anesthesia

Note: “*” means P<0.05.

Abbreviation: COPD, chronic obstructive pulmonary disease.

Figure 2 The nomogram prediction model for postoperative acute heart failure.

Figure 3 The receiver operating characteristic curves of nomogram and different risk factors.

Figure 4 (A) The receiver operating characteristic curves of nomogram in training set. (B) The receiver operating characteristic curves of patients in validation set.

Figure 5 (A) The calibration curve of the nomogram in the training set. (B) The calibration curve of the in the validation set.

Figure 6 The decision curve analysis of the nomogram in the training set.