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Life’s Essential 8 and Life’s Crucial 9 as Prognostic Indicators for Hip Fracture Outcomes: A Multicenter Prospective Cohort Study

Year: 2026

Type: article

Abstract: Objective: To evaluate the prognostic utility of LE8 and LC9 for mortality and functional recovery following hip fracture surgery. Methods: This multicenter prospective cohort study enrolled 1796 patients aged 50 years or older who underwent surgical treatment for hip fracture at two tertiary medical institutions in China between January 2017 and December 2022. Patients were followed for 1 year post-surgery. LE8 and LC9 were calculated on the first day after admission. Discriminative performance was assessed using receiver operating characteristic curve analysis; independent prognostic value was determined using multivariable Cox proportional hazards and logistic regression models. Results: Among 1796 participants, 311 deaths (17.3%) occurred during 1-year follow-up. LC9 demonstrated superior predictive accuracy compared with LE8 for 1-year mortality and free walking ability. Patients with low LE8 and LC9 experienced dramatically elevated 1-year mortality rates and markedly reduced functional recovery. In multivariable analyses, increase in both LE8 and LC9 related to significant mortality risk reduction and improved functional recovery, independent of age, comorbidity burden, and surgical factors. Conclusions: In this multicenter prospective cohort study, LC9 was independently associated with mortality and functional recovery and demonstrated greater discriminative performance than LE8, with psychological health assessment providing critical incremental value. Integration of LC9 into clinical practice may enhance risk stratification and inform targeted perioperative interventions for this vulnerable population.

Source: Clinical Interventions in Aging

DOI: 10.2147/cia.s639216