Prognostic Tools for Predicting Mortality in Older Adults With Hip Fracture: A Systematic Review

Area of Science:

• Gerontology
• Orthopedics
• Epidemiology

Background:

• Hip fracture (HF) is a significant health issue in older adults, leading to severe functional decline, disability, and increased mortality.
• Accurate prognostic tools are needed for personalized clinical decisions in HF management.

Purpose of the Study:

• To systematically review prognostic tools for predicting mortality in patients over 65 with hip fractures.
• To identify tools with the highest predictive capacity for mortality at different time points.

Main Methods:

• A systematic review of studies published up to June 2022 was conducted.
• Searches were performed in PubMed, Scopus, and Web of Science databases.
• Eligibility criteria included single or multicentre studies assessing prognostic tool accuracy for long-term mortality in HF patients over 65.

Main Results:

• Twenty-four eligible publications were identified, mostly prospective observational cohort studies.
• For 30-day mortality, ASAgeCoGeCC score and Almelo Hip Fracture Score showed high predictive capacity (AUC = 0.82).
• A nomogram including clinical and biochemical variables predicted six-month mortality (AUC = 0.83), while the Frail-VIG index best predicted one-year mortality (AUC = 0.90).

Conclusions:

• Significant variability exists in prognostic tools for hip fracture mortality.
• Multidimensional assessments, incorporating clinical, nutritional, functional, cognitive, and social domains, demonstrate superior predictive power for long-term mortality in hip fracture patients.