Goldman score, but not Detsky or Lee indices, predicts mortality 6 months after hip fracture

Azevedo, Paula Schmidt; Gumieiro, David Nicoletti; Polegato, Bertha Furlan; Pereira, Gilberto José Cação; Silva, Igor Almonfrey; Pio, Stephan Milhorini; Cunha, Cacionor Pereira; Fávero, Edson Luiz; Paiva, Sérgio Alberto Rupp de; Minicucci, Marcos F.; Zornoff, Leonardo A. M.

doi:10.1186/s12891-017-1480-x

Cited by 12 publications

(5 citation statements)

References 17 publications

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“…Additionally, one study had a longer follow-up period, with mortality at 24 and 48 months of 26% and 40% in patients without delirium and of 36% and 60% in patients with delirium during hospitalization after a fracture [31]. the predictors identified in this systematic review were grouped into 1) demographic factors: older age [14,17,[20][21][22][23]33,34] and male sex [14,17,33]; 2) clinical factors: comorbidities [15,16,18,20,23,31], high scoring in surgical risk assessment scores [13,17,21,24,33,34,38], functional status before fracture [17,31,33,36], and cognitive/neurological disorders [15,23,31,39]; and 3) intra-hospital factors: infections [15,21,23,26,30] and the time between hospitalization and surgery [20,21,34,35]. Only one study addressed prolonged hospitalization as a factor associated with mortality [16] (S1Table).…”

Section: Resultsmentioning

confidence: 99%

“…The estimated hospital mortality following hip fracture was 10.22% (95% CI and 60% in patients with delirium during hospitalization after a fracture [31]. the predictors identified in this systematic review were grouped into 1) demographic factors: older age [14,17,[20][21][22][23]33,34] and male sex [14,17,33]; 2) clinical factors:…”

Section: Demographicmentioning

confidence: 99%

“…comorbidities [15,16,18,20,23,31], high scoring in surgical risk assessment scores [13,17,21,24,33,34,38], functional status before fracture [17,31,33,36], and cognitive/neurological disorders [15,23,31,39]; and 3) intra-hospital factors: infections [15,21,23,26,30] and the time between hospitalization and surgery [20,21,34,35]. Only one study addressed prolonged hospitalization as a factor associated with mortality [16] (S1Table).…”

Section: Demographicmentioning

confidence: 99%

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Incidence and associated factors of elderly mortality following hip fracture in Brazil: a systematic review and meta-analysis

Peterle

Novaes

Bezerra

et al. 2022

Preprint

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Introduction: Hip fractures are an important health problem worldwide, and several factors are associated with the mortality. This study aimed to investigate the factors associated with hip fractures in the elderly, based on studies on the population residing in Brazil, and the relationship of fractures with mortality. Method: Prospective and retrospective primary observational studies including hospitalized men and/or women aged 60 or older presenting hip fracture due to bone fragility were selected on the Databases. Independent researchers conducted the study selection process and data extraction. A meta-analysis was performed to determine the hospital mortality rate at 90 days, six months, and one year. The Newcastle-Ottawa scale (NOS) was used to assess the quality of the included studies, and the meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Result: Twenty-five studies totalizing 3,949 patients were included in the systematic review. The population was mainly composed of women (2,680/67.86%). Most patients were in the age group of 70 to 80 years old. Meta-analysis findings: 1) hospital mortality (19 studies, n = 3,175), 10.22% (95% CI 7.27–14.17%; I² 88%); 2) 90-day mortality (3 studies, n = 543), 9.74% (95% CI 3.44–24.62%; I² 90%); 3) six-month mortality (3 studies, n = 205), 24.78% (95% CI 17.07–34.51%; I² 51%); 4) one-year mortality (13 studies, n = 2,790), 21.88% (95% CI 17.5–26.99%; I² 88%). The factors most related to mortality in the studies were: 1) demographic: Older age, male sex; 2) Attributed to clinical conditions: high scoring in preoperative risk scores, comorbidities, neurological/cognitive disorders, functional status; and 3) hospital factors: preoperative period and infections. Conclusion: This review identified variables, including functional status and cognitive changes, related to hip fracture mortality. Knowing these predictors allows for early intervention and planning to adapt health systems to the growing demands of the elderly population.

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Section: Resultsmentioning

confidence: 99%

Section: Demographicmentioning

confidence: 99%

Section: Demographicmentioning

confidence: 99%

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Incidence and associated factors of elderly mortality following hip fracture in Brazil: a systematic review and meta-analysis

Peterle

Novaes

Bezerra

et al. 2022

Preprint

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“…3 Despite tremendous advances in geriatric fracture care with the advent of geriatric fracture centers and comanagement, [4][5][6][7] osteoporotic hip fractures are associated with high rates of morbidity and mortality to affected patients. [8][9][10][11] Reports of 1-year mortality rates are as high as 84.4% 8 for patients treated nonoperatively and 38% in operative patients. 9 Patients with multiple medical comorbidities are at an even higher risk of serious complications, morbidity, and death.…”

Section: Introductionmentioning

confidence: 99%

POSSUM and P-POSSUM Scoring in Hip Fracture Mortalities

Johns

Strong

Kates

et al. 2020

Geriatr Orthop Surg Rehabil

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Introduction: Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) and Portsmouth POSSUM (P-POSSUM) are general surgical tools used to efficiently assess mortality and morbidity risk. Data suggest that these tools can be used in hip fracture patients to predict morbidity and mortality; however, it is unclear what score indicates a significant risk on a case-by-case basis. We examined the POSSUM and P-POSSUM scores in a group of hip fracture mortalities in order to assess their accuracy in identification of similar high-risk patients. Materials and Methods: Retrospective analysis of all consecutive mortalities in hip fracture patients at a single tertiary care center over 2 years was performed. Patient medical records were examined for baseline demographics, fracture characteristics, surgical interventions, and cause of death. Twelve physiological and 6 operative variables were used to retrospectively calculate POSSUM and P-POSSUM scores at the time of injury. Results: Forty-seven hip fracture mortalities were reviewed. Median patient age was 88 years (range: 56-99). Overall, 68.1% (32) underwent surgical intervention. Mean predicted POSSUM morbidity and mortality rates were 73.9% (28%-99%) and 31.1% (5%-83%), respectively. The mean predicted P-POSSUM mortality rate was 26.4% (1%-91%) and 53.2% (25) had a P-POSSUM predicted mortality of >20%. Subgroup analysis demonstrated poor agreement between predicted mortality and observed mortality rate for POSSUM in operative (χ2 = 127.5, P < .00001) and nonoperative cohorts (χ2 = 14.6, P < .00001), in addition to P-POSSUM operative (χ2 = 101.9, P < .00001) and nonoperative (χ2 = 11.9, P < .00001) scoring. Discussion/Conclusion: Hip fracture patients are at significant risk of both morbidity and mortality. A reliable, replicable, and accurate tool to represent the expected risk of such complications could help facilitate clinical decision-making to determine the optimal level of care. Screening tools such as POSSUM and P-POSSUM have limitations in accurately identifying high-risk hip fracture patients.

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“…In the United States, the incidence of hip fracture is expected to increase to over 500,000 per year by 2040 1 . Recent mortality 6 months after fracture is about 23% 2 . Readmission rates are also high.…”

Section: Introductionmentioning

confidence: 99%