Abstract:ObjectiveTo investigate the impact of admission clinical characteristics(e.g., age score, sex, marital status, admission type) on one-year postoperative mortality in patients with femoral neck fractures. MethodsStructured Query Language(SQL) was used to extract admission, surgical, and biochemical data of femoral neck fracture patients from the MIMIC-Ⅳ database(version 2.2), followed by data processing. Kaplan-Meier survival analysis was employed to assess the association between different admission clinical characteristics and one-year postoperative mortality, with subgroup analyses stratified by sex and age score. Multivariable Cox proportional hazards regression models were fitted to obtain hazard ratios(HR). ResultsA total of 1726 femoral neck fracture patients were included, of whom 394 died during the observation period and 1332 survived. Kaplan-Meier analysis revealed significantly higher mortality risk in patients aged >75 years vs ≤75 years(P<0.001), males versus females(P=0.006), and varied significantly by marital status(P<0.001). No statistically significant difference was observed between emergency and observational admissions(P=0.290). Patients with government insurance showed elevated mortality risk(P<0.001), as did those with hypertension(P<0.001) or diabetes(P=0.004). Cox regression demonstrated that patients ≥75 years had 2.63-fold higher mortality risk than younger patients; males had 1.75-fold higher risk than females; and widowed patients had 1.32-fold higher risk than married patients. Subgroup analyses revealed certain variations across different admission characteristics. ConclusionElderly, male, widowed, government-insured patients with diabetes or hypertension exhibit significantly higher one-year postoperative mortality. These high-risk populations warrant targeted clinical attention and aggressive preventive interventions to reduce mortality.
