Hip fracture mortality: Predictive models

Area of Science:

• Orthopedics
• Geriatric Medicine
• Health Services Research

Background:

• Preoperative mortality risk estimation in hip fracture patients aids surgical timing, perioperative care, prognosis communication, and inter-unit comparisons.
• Existing mortality risk models exhibit heterogeneity in populations, variables, monitoring, and statistical methods, hindering direct comparisons.
• Most developed models require external validation in diverse populations.

Purpose of the Study:

• To review and compare commonly used hip fracture mortality risk models.
• To highlight the utility of the Nottingham Hip Fracture Score (NHFS) for preoperative risk assessment.

Main Methods:

• Review of existing literature on hip fracture mortality risk prediction models.
• Comparison of the Nottingham Hip Fracture Score (NHFS) and Orthopaedic Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (O-POSSUM).

Main Results:

• The Nottingham Hip Fracture Score (NHFS) and O-POSSUM are the most frequently utilized models.
• The NHFS is characterized by its simplicity and speed of application.
• The NHFS's exclusion of intraoperative variables allows for its use upon patient admission.

Conclusions:

• Accurate preoperative mortality risk stratification is essential for optimal hip fracture management.
• The NHFS presents a practical and efficient tool for early risk assessment in hip fracture patients.
• Further validation of risk models across varied populations is necessary to ensure generalizability.