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<p>Perioperative risk assessment helps inform clinical practice for older people with hip fractures. This is a cohort study, where perioperative risk screening, including NHFS, was performed at admission, followed by an evaluation of 30-day outcomes. 503 patients were included, 73% female, 79.4 ± 9.3&#xa0;years old; 58% presented extracapsular and 42% intracapsular fractures, with a 30-day mortality of 9%. The NHFS was higher in the patients who died at 5.6 ± 1.1 compared to survivals at 4.3 ± 1.5 (p-value &lt; 0.001). NHFS &gt; 4 was associated with 30-day mortality observed by Cox regression adjusted by fracture type: HR 4.55 (95% CI 2.10–9.82) (p-value &lt; 0.001) and Kaplan-Meyer Curve (HR 3.94; 95% CI 2.19–7.07; p-value &lt; 0.001). ROC curve showed the accuracy of NHFS in explaining 30-day mortality (AUC 0.74; 95% CI 0.67–0.81). Complications were higher among patients with NHFS &gt; 4. The performance of NHFS was better than the traditional perioperative risk ASA score. Therefore, NHFS can be implemented in real-world clinical practice to estimate the 30-day mortality risk for hip fracture in older patients in Brazil. NHFS &gt; 4 is critical for 30-day mortality and complications; this cutoff helps inform clinical practice. The present study might motivate other centers to consider NHFS in their perioperative risk assessment routine.</p>

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Performance of the Nottingham hip fracture score (NHFS) as a predictor of 30-day mortality after proximal femur fracture in an older people Brazilian cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月15日

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  • Flávio Cruz Ferro,
  • Marcos Adriano Garcia Campos,
  • Thais Caroline Silva Picolli,
  • Vania de Sá Mayoral,
  • Victoria Moralez Soares,
  • Jessica Caroline Ferreira,
  • Lucas Dias Borges Peres,
  • Theodor Terra Mayer Tibeau,
  • Victor El Chihimi Bernardi,
  • David Nascimento Pereira,
  • David Nicoletti Gumieiro,
  • Emilio Carlos Curcelli,
  • Lais Helena Navarro e Lima,
  • Paulo do Nascimento Junior,
  • Taline Lazzarin,
  • Raquel Simões Ballarin,
  • Marina Politi Okoshi,
  • Marcos Ferreira Minicucci,
  • Sergio Alberto Rupp de Paiva,
  • Adam Lee Gordon,
  • Opinder Sahota,
  • Filipe Welson Leal Pereira,
  • Paula Schmidt Azevedo

摘要

Perioperative risk assessment helps inform clinical practice for older people with hip fractures. This is a cohort study, where perioperative risk screening, including NHFS, was performed at admission, followed by an evaluation of 30-day outcomes. 503 patients were included, 73% female, 79.4 ± 9.3 years old; 58% presented extracapsular and 42% intracapsular fractures, with a 30-day mortality of 9%. The NHFS was higher in the patients who died at 5.6 ± 1.1 compared to survivals at 4.3 ± 1.5 (p-value < 0.001). NHFS > 4 was associated with 30-day mortality observed by Cox regression adjusted by fracture type: HR 4.55 (95% CI 2.10–9.82) (p-value < 0.001) and Kaplan-Meyer Curve (HR 3.94; 95% CI 2.19–7.07; p-value < 0.001). ROC curve showed the accuracy of NHFS in explaining 30-day mortality (AUC 0.74; 95% CI 0.67–0.81). Complications were higher among patients with NHFS > 4. The performance of NHFS was better than the traditional perioperative risk ASA score. Therefore, NHFS can be implemented in real-world clinical practice to estimate the 30-day mortality risk for hip fracture in older patients in Brazil. NHFS > 4 is critical for 30-day mortality and complications; this cutoff helps inform clinical practice. The present study might motivate other centers to consider NHFS in their perioperative risk assessment routine.