Accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity score and the Nottingham risk score in hip fracture patients in Sweden — A prospective observational study

Jonsson, Magnus; Bentzer, Peter; Turkiewicz, Aleksandra; Hommel, Ami

doi:10.1111/aas.13131

Cited by 33 publications

(22 citation statements)

References 29 publications

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“…We have therefore further examined the ability of NHFS to predict a number of other outcome measures commonly experienced by patients admitted with a hip fracture. We observed that NHFS was associated with in-patient mortality with a predictive value (AUC) of 67.4%, which is modest but similar to figures reported from previous studies for predicting 30-day mortality (AUC range 67-72%) [10,19,20]. The ability of NHFS to predict other measures were also significant but weaker, especially for failure to mobilise within 1 day of surgery.…”

Section: Discussionsupporting

confidence: 83%

The Ability of the Nottingham Hip Fracture Score to Predict Mobility, Length of Stay and Mortality in Hospital, and Discharge Destination in Patients Admitted with a Hip Fracture

et al. 2020

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The Nottingham Hip Fracture Score (NHFS) has been developed for predicting 30-day and 1-year mortality after hip fracture. We hypothesise that NHFS may also predict other adverse events. Data from 666 patients (190 men, 476 women), aged 60.2–103.4 years, admitted with a hip fracture to a single centre from 1/10/2015 and 7/12/2017 were analysed. The ability of NHFS to predict mobility within 1 day after surgery, length of stay (LOS) find mortality, and discharge destination was evaluated by receiver operating characteristic curves and two-graph plots. The area under the curve (95% confidence interval [CI]) for predicting mortality was 67.4% (58.4–76.4%), prolonged LOS was 59.0% (54.0–64.0%), discharge to residential/nursing care was 62.3% (54.0–71.5%), and any two of failure to mobilise, prolonged LOS or discharge to residential/nursing care was 64.8% (59.0–70.6%). NHFS thresholds at 4 and 7 corresponding to the lower and upper limits of intermediate range where sensitivity and specificity equal 90% were identified for mortality and prolonged LOS, and 4 and 6 for discharge to residential/nursing care, which were used to create three risk categories. Compared with the low risk group (NHFS = 0–4), the high risk group (NHFS = 7–10 or 6–10) had increased risk of in-patient mortality: rates = 2.0% versus 7.1%, OR (95% CI) = 3.8 (1.5–9.9), failure to mobilise within 1 day of surgery: rates = 18.9% versus 28.3%, OR = 1.7 (1.0–2.8), prolonged LOS (> 17 days): rates = 20.3% versus 33.9%, OR = 2.2 (1.3–3.3), discharge to residential/nursing care: rates = 4.5% vs 12.3%, OR = 3.0 (1.4–6.4), and any two of failure to mobilise, prolonged LOS or discharge to residential/nursing care: rates = 10.5% versus 28.6%, 3.4 (95% CI 1.9–6.0), and stayed 4.1 days (1.5–6.7 days) longer in hospital. High NHFS associates with increased risk of mortality, prolonged LOS and discharge to residential/nursing care, lending further support for its use to identify adverse events.

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Section: Discussionsupporting

confidence: 83%

The Ability of the Nottingham Hip Fracture Score to Predict Mobility, Length of Stay and Mortality in Hospital, and Discharge Destination in Patients Admitted with a Hip Fracture

et al. 2020

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“…Accordingly, hip fracture mortality risk prediction scores do not include fracture type beyond the broad categorisation we have used. 36,37 Our analysis studied 30-day mortality. We did not have data on cause of death which meant that we could not attempt to determine which deaths may have been associated with, or attributable to, the choice of surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Higher 30-day mortality associated with the use of intramedullary nails compared with sliding hip screws for the treatment of trochanteric hip fractures

Whitehouse

Berstock

Kelly

et al. 2019

The Bone & Joint Journal

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Aims The aim of this study was to investigate the association between the type of operation used to treat a trochanteric fracture of the hip and 30-day mortality. Patients and Methods Data on 82 990 patients from the National Hip Fracture Database were analyzed using generalized linear models with incremental case-mix adjustment for patient, non-surgical and surgical characteristics, and socioeconomic factors. Results The use of short and long intramedullary nails was associated with an increase in 30-day mortality (adjusted odds ratio (OR) 1.125, 95% confidence interval (CI) 1.040 to 1.218; p = 0.004) compared with the use of sliding hip screws (12.5% increase). If this were causative, it would represent 98 excess deaths over the four-year period of the study and one excess death would be caused by treating 112 patients with an intramedullary nail rather than a sliding hip screw. Conclusion There is a 12.5% increase in the risk of 30-day mortality associated with the use of an intramedullary nail compared with a sliding hip screw in the treatment of a trochanteric fractures of the hip.

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“…At present, there are many studies of the prediction on short- or long-term mortality in elderly patients with hip fracture, and the early warning system/indicator on perioperative MODSE has rarely been reported. 4–7 In addition, the conceptualization of “adverse events” or “complications” in the aforementioned study was difficult to define and standardize. As a classical marker of myocardial injury, hs-TnT has been widely used in the diagnosis, stratification and prognostic evaluation of ACS.…”

Section: Discussionmentioning

confidence: 99%

“…as predictors for postoperative adverse events. 4–7 hs-TnT, as a marker of myocardial injury, has been widely used in the diagnosis and prognostic evaluation of acute coronary syndrome(ACS) and has been confirmed to be associated with the prognosis of many non-coronary diseases such as sepsis, chronic obstructive pulmonary disease, and acute ischemic stroke. 8–12 However, there are little studies on the effect of hs-TnT on the short-term prognosis of elderly patients with hip fracture.…”

Section: Introductionmentioning

confidence: 99%

Association Between High-Sensitivity Troponin T on Admission and Organ Dysfunction During Hospitalization in Patients Aged 80 Years and Older with Hip Fracture: A Single-Centered Prospective Cohort Study

Qin¹,

Wu²,

Deng³

et al. 2021

CIA

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Background Prognostic evaluation of elderly patients with hip fracture is an issue that has been highly concerned by clinicians. Only a few studies have focused on organ dysfunction after hip fracture in the elderly. This study aimed to investigate the association between high-sensitivity troponin T (hs-TnT) at admission and organ dysfunction during hospitalization in elderly patients with hip fracture. Methods We enrolled 168 patients with hip fracture who were aged 80 years and older at Geriatric Orthopaedic Center of Sichuan Provincial Orthopedic Hospital between January 2020 and August 2020. Baseline characteristics, perioperative information, and short-term clinical outcomes were analyzed. Results Of the 208 patients admitted during the study period, 168 met the inclusion criteria; of these, 91 (54.2%) had higher hs-TnT than the 99th percentile in the normal population. After adjustment for confounders, elevated hs-TnT was independently associated with multiple organ dysfunction syndrome in the elderly (MODSE) (adjusted OR, 5.76; 95% CI, 1.74–19.10; P = 0.004), heart dysfunction (adjusted OR, 7.48; 95% CI, 2.17–25.82; P = 0.001), MODS severity score > 3 (adjusted OR, 5.22; 95% CI, 1.32–20.60; P = 0.018), and length of hospital stay > 14 days (adjusted OR, 2.38; 95% CI, 1.05–5.36; P = 0.037). Conclusion Increased hs-TnT on admission is an independent risk factor for MODSE after hip fracture in patients aged 80 years and older. Effective measures should be applied to avoid progression of MODSE from pre-failure stage to failure stage.

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Accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity score and the Nottingham risk score in hip fracture patients in Sweden — A prospective observational study

Cited by 33 publications

References 29 publications

The Ability of the Nottingham Hip Fracture Score to Predict Mobility, Length of Stay and Mortality in Hospital, and Discharge Destination in Patients Admitted with a Hip Fracture

The Ability of the Nottingham Hip Fracture Score to Predict Mobility, Length of Stay and Mortality in Hospital, and Discharge Destination in Patients Admitted with a Hip Fracture

Higher 30-day mortality associated with the use of intramedullary nails compared with sliding hip screws for the treatment of trochanteric hip fractures

Association Between High-Sensitivity Troponin T on Admission and Organ Dysfunction During Hospitalization in Patients Aged 80 Years and Older with Hip Fracture: A Single-Centered Prospective Cohort Study

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