Perioperative medicine & outcomes
Risk Analysis Index for Estimation of 30-Day Postoperative Mortality in Hip Fractures
Authors' conclusion
In this cross-sectional study of 114 359 patients, the RAI demonstrated superior odds and discriminatory accuracy for estimating 30-day mortality following surgical management of hip fractures.
Study context
- Population
- Patients aged 65 years with surgically managed traumatic hip fracture, 2015 to 2019
- Participants
- 114,359 patients
- Exposure
- Risk Analysis Index (RAI) vs mFI-5 frailty indices for estimating 30-day mortality
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsregistry database (ACS NSQIP), Data collection May to June 2024
- Registry database (ACS NSQIP)
- Data collection May to June 2024
Main finding
As reported in the abstract
Discriminatory accuracy for 30-day mortality
| Group | AUC |
|---|---|
| RAI | 0.73 [95% CI, 0.72-0.73] |
| mFI-5 | 0.61 [95% CI, 0.60-0.62] |
AUC
RAI0.73 [95% CI, 0.72-0.73]
mFI-50.61 [95% CI, 0.60-0.62]
- RAI vs mFI-5: P < 0.001
Observational data: associations, not effects.
Further findings
30-day mortality by mFI-5 frailty status
| OR (95% CI) | P value | ||
|---|---|---|---|
| PrefrailMultivariable regression | 1.35 (1.24–1.47) | P < 0.001 | |
| FrailMultivariable regression | 2.11 (1.94–2.30) | P < 0.001 | |
| Severely frailMultivariable regression | 3.53 (3.20–3.90) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
30-day mortality by RAI frailty status
| OR (95% CI) | P value | ||
|---|---|---|---|
| NormalMultivariable regression | 1.55 (1.35–1.79) | P < 0.001 | |
| FrailMultivariable regression | 2.97 (2.59–3.42) | P < 0.001 | |
| Very frailMultivariable regression | 6.17 (5.38–7.08) | P < 0.001 | |
| 0.10.31310Odds ratio (log scale) |
Original publication
Risk Analysis Index for Estimation of 30-Day Postoperative Mortality in Hip Fractures. JAMA Netw Open. Published 1 May 2025. doi:10.
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