The primary objective of this study is to develop and validate a machine learning model that integrates preoperative clinical data, biomarkers, and modified frailty indices (mFI-5) to accurately predict myocardial injury after non-cardiac surgery (MINS) in geriatric patients ($\\ge$65 years) undergoing major orthopedic surgery and requiring postoperative intensive care. The research aims to compare the predictive performance of advanced algorithms, such as XGBoost and Random Forest, against traditional clinical risk scores like the Revised Cardiac Risk Index (RCRI), while specifically evaluating the impact of frailty on the model's area under the curve (AUC). Furthermore, by identifying the most critical preoperative predictors, this study seeks to establish an objective clinical decision support mechanism to guide clinicians in the early risk stratification of high-risk geriatric patients.
Who can participate
Age range
65 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* All patients aged 65 years and older.
* Patients undergoing major orthopedic surgery (hip fracture repair, total knee/hip arthroplasty, and revision surgeries).
* Patients operated on within the designated study period (January 2021 - December 2023).
* Patients with complete access to preoperative clinical data (comorbidities, medication use) and baseline laboratory parameters (Hemoglobin, Creatinine, Albumin).
* Patients who had at least one postoperative cardiac troponin (hs-cTn) measurement within the first 72 hours after surgery.
Exclusion Criteria:
* Patients with a documented history of acute myocardial infarction or elevated baseline troponin levels in the preoperative period (to differentiate acute injury from surgical causes).
* Patients with end-stage renal disease (ESRD) requiring dialysis (as chronic kidney dysfunction persistently elevates baseline troponin levels).
* Patients with missing critical preoperative data or incomplete postoperative troponin follow-up.
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1This study is specifically looking at older patients having hip surgery — given my age and health situation, does my profile match the kind of patients being followed in this research, and would my surgical team be measuring troponin levels after my operation to check for heart muscle injury?
2Since this trial is actively tracking something called MINS — myocardial injury after non-cardiac surgery — how concerned should I be about this risk for my own hip surgery, and what signs or symptoms should I watch for afterward?
3The study is also looking at frailty as a predictor of complications — has my care team assessed my frailty level before surgery, and how might that assessment change the plan for my procedure or recovery?
4This trial is observational and no longer enrolling, so it's gathering data rather than testing a new treatment — does that mean the findings could eventually change how my surgical team monitors my heart health after my operation?
5Are there standard-of-care monitoring steps for heart injury after hip surgery that I should be asking for regardless of this study, especially given that this trial suggests it's a meaningful enough risk to formally investigate?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Incidence of Myocardial Injury after Non-cardiac Surgery (MINS)