{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:46:49Z","timestamp":1785509209951,"version":"3.56.0"},"reference-count":61,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Total hip arthroplasty (THA) remains the primary treatment option for femoral neck fractures in elderly patients. This study aims to explore the risk factors associated with allogeneic blood transfusion after surgery and to develop a dynamic prediction model to predict post\u2010operative blood transfusion requirements. This will provide more accurate guidance for perioperative humoral management and rational allocation of medical resources.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed data from 829 patients who underwent total hip arthroplasty for femoral neck fractures at three third\u2010class hospitals between January 2017 and August 2023. Patient data from one hospital were used for model development, whereas data from the other two hospitals were used for external validation. Logistic regression analysis was used to screen the characteristic subsets related to blood transfusion. Various machine learning algorithms, including logistic regression, SVA (support vector machine), K\u2010NN (k\u2010nearest neighbors), MLP (multilayer perceptron), naive Bayes, decision tree, random forest, and gradient boosting, were used to process the data and construct prediction models. A 10\u2010fold cross\u2010validation algorithm facilitated the comparison of the predictive performance of the models, resulting in the selection of the best\u2010performing model for the development of an open\u2010source computing program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>BMI (body mass index), surgical duration, IBL (intraoperative blood loss), anticoagulant history, utilization rate of tranexamic acid, Pre\u2010Hb, and Pre\u2010ALB were included in the model as well as independent risk factors. The average area under curve (AUC) values for each model were as follows: logistic regression (0.98); SVA (0.91); k\u2010NN (0.87) MLP, (0.96); naive Bayes (0.97); decision tree (0.87); random forest (0.96); and gradient boosting (0.97). A web calculator based on the best model is available at: (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/nomo99.shinyapps.io\/dynnomapp\/\">https:\/\/nomo99.shinyapps.io\/dynnomapp\/<\/jats:ext-link>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Utilizing a computer algorithm, a prediction model with a high discrimination accuracy (AUC\u2009&gt;\u20090.5) was developed. The logistic regression model demonstrated superior differentiation and reliability, thereby successfully passing external validation. The model's strong generalizability and applicability have significant implications for clinicians, aiding in the identification of patients at high risk for postoperative blood transfusion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14160","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T04:39:30Z","timestamp":1719895170000},"page":"2066-2080","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Development and Validation of a Machine Learning Algorithm to Predict the Risk of Blood Transfusion after Total Hip Replacement in Patients with Femoral Neck Fractures: A Multicenter Retrospective Cohort Study"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6850-4254","authenticated-orcid":false,"given":"Jieyang","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Orthopedics Affiliated Hospital of Jiaxing University  Jiaxing 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