Examining the relationships between patients’ multimorbidity trajectories and prognostic outcomes after the initial hip fracture

Abstract Hip fractures significantly affect patients’ health and quality of life. Despite therapeutic treatments, many patients continue to experience poor prognoses that include recurrent fractures and mortality, especially the older ones. Therefore, understanding important factors associated with...

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Main Authors: Jessica Qiuhua Sheng, Da Xu, Paul Jen-Hwa Hu, Liang Li, Ting-Shuo Huang
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-79642-2
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author Jessica Qiuhua Sheng
Da Xu
Paul Jen-Hwa Hu
Liang Li
Ting-Shuo Huang
author_facet Jessica Qiuhua Sheng
Da Xu
Paul Jen-Hwa Hu
Liang Li
Ting-Shuo Huang
author_sort Jessica Qiuhua Sheng
collection DOAJ
description Abstract Hip fractures significantly affect patients’ health and quality of life. Despite therapeutic treatments, many patients continue to experience poor prognoses that include recurrent fractures and mortality, especially the older ones. Therefore, understanding important factors associated with post-fracture prognoses is critical. This study focuses on patients’ multimorbidity trajectories and examines how the trajectory’s time span, number of coexisting chronic diseases, and sequential disease patterns relate to distinct prognostic outcomes. From the National Health Insurance Research Database in Taiwan, we obtain a sample of 128,822 patients who suffered an initial hip fracture between 1996 and 2011. We use this sample to analyze the relationships between multimorbidity trajectories and prognostic outcomes after an initial hip fracture. The results reveal that a patient’s multimorbidity trajectory’s time span and number of chronic diseases significantly associate with his or her post-fracture prognosis. In addition, essential sequential patterns of chronic diseases relate to post-fracture prognoses too. We then leverage the discovered relationships to develop a cross-attention neural network method for estimating patients’ post-fracture prognoses and demonstrate its predictive utilities relative to several prevalent machine leaning methods. This study underscores the importance of leveraging the time span, number of chronic diseases, and sequential disease patterns in patients’ multimorbidity trajectory profile to estimate their prognoses within three years of an initial hip fracture, which can support physicians’ clinical decisions and patient management.
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spelling doaj-art-dfcf3fc88c834705b46d2e771bc69f932025-02-02T12:25:09ZengNature PortfolioScientific Reports2045-23222024-11-0114111110.1038/s41598-024-79642-2Examining the relationships between patients’ multimorbidity trajectories and prognostic outcomes after the initial hip fractureJessica Qiuhua Sheng0Da Xu1Paul Jen-Hwa Hu2Liang Li3Ting-Shuo Huang4Department of Systems and Operations Management, David Nazarian College of Business and Economics, California State University NorthridgeDepartment of Marketing, Analytics and Professional Sales, School of Business Administration, University of MississippiDepartment of Operations and Information Systems, David Eccles School of Business, University of UtahSchool of Economics and Management, Southwest Jiaotong UniversityDivision of General Surgery, Department of Surgery, Jen-Ai HospitalAbstract Hip fractures significantly affect patients’ health and quality of life. Despite therapeutic treatments, many patients continue to experience poor prognoses that include recurrent fractures and mortality, especially the older ones. Therefore, understanding important factors associated with post-fracture prognoses is critical. This study focuses on patients’ multimorbidity trajectories and examines how the trajectory’s time span, number of coexisting chronic diseases, and sequential disease patterns relate to distinct prognostic outcomes. From the National Health Insurance Research Database in Taiwan, we obtain a sample of 128,822 patients who suffered an initial hip fracture between 1996 and 2011. We use this sample to analyze the relationships between multimorbidity trajectories and prognostic outcomes after an initial hip fracture. The results reveal that a patient’s multimorbidity trajectory’s time span and number of chronic diseases significantly associate with his or her post-fracture prognosis. In addition, essential sequential patterns of chronic diseases relate to post-fracture prognoses too. We then leverage the discovered relationships to develop a cross-attention neural network method for estimating patients’ post-fracture prognoses and demonstrate its predictive utilities relative to several prevalent machine leaning methods. This study underscores the importance of leveraging the time span, number of chronic diseases, and sequential disease patterns in patients’ multimorbidity trajectory profile to estimate their prognoses within three years of an initial hip fracture, which can support physicians’ clinical decisions and patient management.https://doi.org/10.1038/s41598-024-79642-2Multimorbidity trajectoryHip-fracture patient managementRecurrent fracturesClinical decision supportPrognosis predictions
spellingShingle Jessica Qiuhua Sheng
Da Xu
Paul Jen-Hwa Hu
Liang Li
Ting-Shuo Huang
Examining the relationships between patients’ multimorbidity trajectories and prognostic outcomes after the initial hip fracture
Scientific Reports
Multimorbidity trajectory
Hip-fracture patient management
Recurrent fractures
Clinical decision support
Prognosis predictions
title Examining the relationships between patients’ multimorbidity trajectories and prognostic outcomes after the initial hip fracture
title_full Examining the relationships between patients’ multimorbidity trajectories and prognostic outcomes after the initial hip fracture
title_fullStr Examining the relationships between patients’ multimorbidity trajectories and prognostic outcomes after the initial hip fracture
title_full_unstemmed Examining the relationships between patients’ multimorbidity trajectories and prognostic outcomes after the initial hip fracture
title_short Examining the relationships between patients’ multimorbidity trajectories and prognostic outcomes after the initial hip fracture
title_sort examining the relationships between patients multimorbidity trajectories and prognostic outcomes after the initial hip fracture
topic Multimorbidity trajectory
Hip-fracture patient management
Recurrent fractures
Clinical decision support
Prognosis predictions
url https://doi.org/10.1038/s41598-024-79642-2
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