| Sumario: | Purpose: To compare the predictive performance of a decision tree analysis against that of a logistic regression in identifying the frailty status 3 months post‐discharge among older adults hospitalized for a hip fracture. Methods: A prospective, longitudinal study was conducted at two medical centers in northern Taiwan between April 2022 and February 2023. Participants (N = 238) were recruited from orthopedic wards using convenience sampling. The study examined various admission‐based predictors, including physiological, psychological, and social factors, along with the initial frailty status. Results: The decision tree model achieved 96.2% accuracy, with 95.5% sensitivity and 98.3% specificity in predicting the frailty status; across 100 repeated stratified 70:30 hold‐out splits, mean AUROC was 0.829 (SD = 0.059) for the decision tree and 0.890 (SD = 0.041) for logistic regression, and the difference between models was not statistically significant (DeLong p = 0.906). Depression emerged as the root node, with a threshold Geriatric Depression Scale (GDS)‐15 score of ≥ 2.5, which was significantly associated with frailty, followed by the St. Louis University Mental Status (SLUMS) score, grip strength, 25‐hydroxyvitamin D level, age, frailty status at admission, sleep quality, serum albumin, and pain as additional predictive factors. The multivariate logistic regression analysis identified several significant predictors of frailty at 3 months post‐discharge: female sex (odds ratio (OR) = 0.04, p = 0.004), grip strength (OR = 0.85, p = 0.048), serum albumin (OR = 0.11, p = 0.045), a higher depression score (OR = 2.18, p = 0.009), SLUMS cognitive function score (OR = 0.63, p = 0.003), a higher sleep quality score (OR = 1.93, p = 0.004), and frailty at admission (OR = 80.87, p = 0.002). Conclusions: Both predictive models demonstrated strong performances in identifying post‐discharge frailty risk, with the decision tree analysis offering particularly high accuracy. The findings suggest that multiple factors, especially the psychological status at admission, play crucial roles in the development of post‐discharge frailty among older adults with a hip fracture. External validation of the identified thresholds in independent multicenter cohorts is required before clinical application.
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