Relevant factors of lumbar compression fracture patients’ death 1 year after surgery and its prediction model creation and validation

Abstract

This study aimed to investigate the risk factors associated with 1-year postoperative mortality in patients with lumbar compression fractures and to construct and validate a predictive nomogram model. Clinical data of patients admitted between January 2021 and December 2024 were retrospectively analyzed. Independent predictors of 1-year mortality were identified using univariate and multivariate logistic regression analyses. A nomogram was constructed based on the final model. Model discrimination was evaluated using the receiver operating characteristic curve and the area under the curve. Calibration, Bootstrap resampling, and 10-fold cross-validation were used for internal validation. A total of 378 patients were included, of whom 21 (5.56%) died within 1 year postoperatively. Five independent predictors were identified: bone mineral density ≤ −2.5, multiple segmental fractures, age > 70 years, albumin ≤ 40 g/L, and neutrophil-to-lymphocyte ratio > 4. The nomogram showed good discriminative performance, with an area under the curve of 0.826 in the training cohort and 0.813 in the validation cohort. Calibration curves demonstrated good agreement between predicted and observed outcomes. One-year postoperative mortality in lumbar compression fracture patients is influenced by multiple clinical and inflammatory factors. The proposed nomogram demonstrates good discriminative ability and may help clinicians identify high-risk patients for early intervention.