Validation of the Nottingham Hip Fracture Score as a predictor of 30-day mortality after hip surgery

Abstract

Purpose: To assess whether the Nottingham Hip Fracture Score (NHFS) can predict mortality in the first 30 days after hip surgery. Material and methods: Upon admission, 216 patients were assessed for age, sex, mobility status (bedridden, assisted or unassisted walking), living accommodations (residential or institutionalized), fracture type (intra- or extracapsular), comorbidities (cardiovascular, stroke, respiratory, renal, diabetes), malignant disease, and cognition (Mini-Mental Status Examination). We applied the NHFS, which evaluates seven factors, with scores that range from 0 to 10, as a predictor of 30-day mortality after hip surgery. Results: Survivor scores showed greater variability (CV=0.28) than those of non-survivors (CV=0.20). The receiver operating characteristic curve identified a score of 5.5 as the optimal cutoff point. At this point, the test’s sensitivity and specificity indicate the simultaneous maximum likelihood of 30-day survival or non-survival. Conclusion: The NHFS is a robust predictor of 30-day mortality after hip surgery and an updated equation has been validated for the patients in this sample, which increases its clinical credibility.