Machine learning-based prediction of short- and long-term mortality for shared decision-making in older hip fracture patients: the Dutch Hip Fracture Audit algorithms in 74,396 cases

Topic: Risk, prevention and care in population studies

74,396 patients (median age 84, IQR 78-89; 68% female) were analyzed. Most patients lived at home (69%) and high malnutrition risk was seen in 10%. 18% had dementia. Mortality rates were 9.1% (30-day), 15% (90-day), and 26% (1-year). Logistic regression performed comparably to other algorithms, but was chosen as the preferred algorithm due to its superior interpretability (c-statistic: 30-day 0.82, 90-day 0.81, 1-year 0.80). We developed and validated ML algorithms, including logistic regression, for mortality prediction in older hip fracture patients with adequate performance. This information may inform SDM.

Key findings

• 74,396 patients (median age 84, IQR 78-89; 68% female) were analyzed.
• Most patients lived at home (69%) and high malnutrition risk was seen in 10%. 18% had dementia.
• Mortality rates were 9.1% (30-day), 15% (90-day), and 26% (1-year).
• Logistic regression performed comparably to other algorithms, but was chosen as the preferred algorithm due to its superior interpretability (c-statistic: 30-day 0.82, 90-day 0.81, 1-year 0.80).
• We developed and validated ML algorithms, including logistic regression, for mortality prediction in older hip fracture patients with adequate performance.

Why it matters

Machine learning algorithms, including logistic regression, were developed and validated to predict short- and long-term mortality in older hip fracture patients, 18% of whom had dementia. This information may inform shared decision-making, but the study is about predicting mortality after hip fracture, not about treating, curing, or preventing Alzheimer's disease.

New to this subject? Start with our plain-English guide: Digital health →

Study details

• Study designcohort study
• Participants74,396
• Effect size9.1%
• Evidence strengthModerate

Read the original

• DOI: 10.2340/17453674.2025.44248
• PubMed: 40622227
• Original source →
• Free full text: Acta Orthopaedica →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{dijkstra2025-40622227,
  author  = {Dijkstra, Hidde and Parsons, Cathleen S and van Bremen, Hanne-Eva and Willems, Hanna C. and de Hond, Anne and Van Munster, Barbara C. and Doornberg, Job Nicolaas and Oosterhoff, Jacobien H. F.},
  title   = {{Machine learning-based prediction of short- and long-term mortality for shared decision-making in older hip fracture patients: the Dutch Hip Fracture Audit algorithms in 74,396 cases}},
  journal = {Acta Orthopaedica},
  year    = {2025},
  doi     = {10.2340/17453674.2025.44248},
  pmid    = {40622227},
  url     = {https://doi.org/10.2340/17453674.2025.44248}
}

Related studies in Digital health tools

• Prediction of Postoperative Delirium in Geriatric Hip Fracture Patients: A Clinical Prediction Model Using Machine Learning Algorithms Geriatric orthopaedic surgery & rehabilitation · 2021-12-13 · usefulness score 52/100
• An FDG-PET–Based Machine Learning Framework to Support Neurologic Decision-Making in Alzheimer Disease and Related Disorders Neurology · 2025-06-27 · usefulness score 58/100
• Machine-learning-based COVID-19 mortality prediction model and identification of patients at low and high risk of dying Critical care (London, England) · 2021-09-08 · usefulness score 55/100
• Comprehensive Machine Learning-Based Prediction Model for Delirium Risk in Older Patients with Dementia: Risk Factors Identification Clinical Interventions in Aging · 2025-05-01 · usefulness score 43/100
• Machine Learning Algorithm Using Electronic Chart-Derived Data to Predict Delirium After Elderly Hip Fracture Surgeries: A Retrospective Case-Control Study Frontiers in surgery · 2021-07-13 · usefulness score 57/100
• Machine Learning for Predicting Postoperative Functional Disability and Mortality Among Older Patients With Cancer: Retrospective Cohort Study JMIR Aging · 2025-05-14 · usefulness score 53/100

Also tagged “delirium”

858 studies in the library carry the topic tag “delirium”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 858 tagged studies.

• Nature, prevalence and factors associated with depression among the elderly in a rural south Indian community International psychogeriatrics · 2009-02-26 · usefulness score 51/100 · Disparities
• Covid-19 and Aging: Challenges and Opportunities The Journals of Gerontology Series A · 2022-07-01 · usefulness score 39/100 · Health systems and care delivery
• The Oldest Old in the Last Year of Life: Population‐Based Findings from Cambridge City over‐75s Cohort Study Participants Aged 85 and Older at Death Journal of the American Geriatrics Society · 2010-01-01 · usefulness score 46/100 · Health systems and care delivery

Similar studies

• Development and Validation of a Deep Learning Algorithm for Mortality Prediction in Selecting Patients With Dementia for Earlier Palliative Care Interventions 2019 · Clinical safety
• Fewer patients undergo surgery when adding a comprehensive geriatric assessment in older patients with a hip fracture 2020 · End-of-life care
• Machine learning diagnosis of cognitive impairment and dementia in harmonized older adult cohorts 2025 · Digital health tools
• Long‐Term Mortality Predictors Using a Machine‐Learning Approach in Patients With Chronic Limb‐Threatening Ischemia After Peripheral Vascular Intervention 2024 · Health systems and care delivery
• Using Machine Learning to Predict Cognitive Decline in Older Adults From the Chinese Longitudinal Healthy Longevity Survey: Model Development and Validation Study 2025 · Biomarkers
• Dementia and delirium, the outcomes in elderly hip fracture patients 2017 · Clinical safety

More on Digital health tools

• A review that covers this ground Machine Learning Algorithms and Statistical Approaches for Alzheimer's Disease Analysis Based on Resting-State EEG Recordings: A Systematic Review International journal of neural systems · 2021-02-16 · usefulness score 55/100
• Newest in this subject Speaker-Wise Dementia Screening fromNaturalistic Speech with Lexical Entropy, Semantic Drift, and Multimodal Fusion Research Square · 2026-10-21 · Preprint — not yet peer-reviewed · usefulness score 16/100
• Newest in this subject Integrating Multisource Target Evidence with Machine-Learning Potency Prediction for Alzheimer’s Disease Drug Discovery bioRxiv · 2026-10-20 · Preprint — not yet peer-reviewed · usefulness score 16/100

See all studies in Digital health tools →