Evidence mapPaperPMID 41493997Full record

ArticlePloS one2026

Impact of chronic obstructive pulmonary disease on mortality in elderly patients with hip fracture: A retrospective cohort study.

Jiaxuan Zhu, Yu Chang, Xiaomin Wang, Yuying Li, Fan Yang, Yuwei Shi, Xiuguo Zhang

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Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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5 · Who and what money

Authors and funding

7 authors.

Jiaxuan ZhuDepartment of Nursing, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.ORCID https://orcid.org/0009-0008-3705-6004
Yu ChangDepartment of Nursing, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
Xiaomin WangDepartment of Nursing, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
Yuying LiDepartment of Nursing, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
Fan YangDepartment of Nursing, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
Yuwei ShiDepartment of Nursing, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
Xiuguo ZhangDepartment of Nursing, The Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.ORCID https://orcid.org/0009-0005-2053-4733

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveChronic obstructive pulmonary disease (COPD) is thought to increase mortality risk in elderly patients with hip fracture, but its independent effect remains unclear. This study aimed to determine whether COPD is an independent predictor of mortality in this population.

methodsA retrospective cohort study was conducted on elderly patients with hip fractures. Through propensity score matching, confounding factors between patients with chronic obstructive pulmonary disease (COPD) and those without COPD were balanced. LASSO and Cox regression methods were used to identify predictors of mortality. The performance of the model was evaluated via ROC curves, calibration curves, and decision curve analysis. Restrictive cubic spline analysis and subgroup analysis were also performed to assess nonlinear effects and interactions.

resultsA total of 151 (11.08%) of the 1362 participants who were enrolled in the trial had COPD. After PSM, 537 data points were analysed. The COPD group presented a significantly greater incidence of postoperative respiratory failure (6.04%) and delirium (12.08%) and significantly greater 1-year mortality (22.82% vs. 5.93%). COPD was identified as a strong independent predictor of mortality (HR 7.291, 95% CI: 3.619 ~ 14.691). Other independent risk factors included age (HR 1.066, 95% CI: 1.016 ~ 1.118), HCT (HR 0.922, 95% CI: 0.872 ~ 0.975), CAR (HR 1.476, 95% CI: 1.209 ~ 1.801), and BNP (HR 1.001, 95% CI: 1.000 ~ 1.001). The prediction model showed good predictive efficiency, achieving an AUC of 0.834 (95% CI: 0.766, 0.902) in the training set and 0.892 (95% CI: 0.819, 0.965) in the validation set. Restricted cubic splines confirmed linear relationships between continuous predictors and mortality risk (all P values for nonlinearity > 0.05). Subgroup analysis revealed a significant interaction effect between sex and COPD (p = 0.028).

conclusionsCOPD is a strong independent risk factor for 1-year mortality in elderly hip fracture patients. The developed prediction model can help clinicians identify high-risk patients early and implement personalized management strategies.

Indexed as

Hip FracturesPulmonary Disease, Chronic ObstructiveAgedAged, 80 and overFemaleHumansMaleProportional Hazards ModelsRetrospective StudiesRisk FactorsROC Curve

Identifiers

PMID41493997
PMCPMC12774376

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.