Predicting the risk of sarcopenia in elderly patients with patellar fracture: Development and assessment of a new predictive nomogram

Abstract

Patients and methods:We conducted a community survey of patients aged ≥ 55 years who underwent surgery for patellar fractures between January 2013 and October 2018, through telephone interviews, community visits, and outpatient follow-up. We established a predictive model for assessing the risk of sarcopenia after patellar fractures. We developed the prediction model by combining multivariate logistic regression analysis with the least absolute shrinkage model and selection operator regression (Lasso analysis). The predictive quality and clinical utility of the predictive model were determined using C-index, calibration plots, and decision curve analysis. We conducted internal sampling methods for qualitative assessment. Result:We recruited 61 participants (males: 20, mean age: 68.1 years). Various risk factors were assessed, and low body mass index and diabetes mellitus were identified as the most important risk factors (P<0.05).The model showed a good prediction rate (C-index: 0.909; 95% confidence interval: 0.81-1.00) and good correction effect. The C-index remained high (0.828) even after internal sample verification. Decision curve analysis showed that the risk of sarcopenia was 8.3-80.0%, suggesting good clinical practicability.Conclusion: Our prediction model shows promise as a cost-effective tool for predicting the risk of postoperative sarcopenia in elderly patients based on the following: advanced age, low body mass index, diabetes, longer postoperative hospital stay, no higher education, no postoperative rehabilitation, removal of internal fixation, and less outdoor exercise.We believe that the AWGS criteria can be used to predict the occurrence of sarcopenia after patellar surgery by establishing an effective nomogram model.The aim of this study was to develop an effective and simple tool for predicting sarcopenia in patients undergoing post-fracture patellar surgery. Only the data available for period after the patient's hospitalization for fracture were used to evaluate the risk of sarcopenia in patients with patella fracture in order to study the effects of early prevention of sarcopenia and obtain accurate guidance for clinical work. Patients and methods PatientsThis study was designed as a retrospective investigation of the prognosis of elderly patients with patella fracture. conducted a questionnaire-based survey through appointment-based telephonic interview, outpatient services, and community follow-up. Data for all the patients were collected by the same researcher.Written informed consent was sought from all enrolled subjects before participation in the study; all participating patients provided consent. In this study, we included only fracture patients aged ≥ 55 years, since postoperative sarcopenia after fractures is rare in young patients. The laboratory blood test results taken into consideration were those obtained for the preoperative fasting samples of venous blood. Inclusion criteria and exclusion criteriaThe inclusion criteria for the survey were as follows: (1) diagnosis of sarcope...