Performance of the Nottingham Hip Fracture Score and Clinical Frailty Scale as predictors of short and long-term outcomes: a dual-centre 3-year observational study of hip fracture patients

Thorne, George D.; Hodgson, Luke

doi:10.1007/s00774-020-01187-x

Cited by 20 publications

(28 citation statements)

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“…However, there was no significant difference in Thorne's study. One of the reasons may be that patients who previously lived in a nursing home and death were not included ( 23 ). Moreover, the number of studies and sample size were both small, and more research was required in the future to explore the predictive value of frailty on discharge destination.…”

Section: Discussionmentioning

confidence: 99%

“…Two reviewers (YS and ZW) independently assessed the quality using the Newcastle-Ottawa Scale (NOS) (More details in Supplementary File 2). In 11 included studies, 4 were prospective cohort studies (6,16,18,19) and the remaining 7 were retrospective cohort studies (15,17,(20)(21)(22)(23)(24). The studies were implemented in the Netherlands (19), America (15), Singapore (16), Canada (17), China (18), Korea (20,22), Australia (21), Italy (6), Japan (24) and England (23).…”

Section: Characteristics and Quality Of The Included Studiesmentioning

confidence: 99%

“…In 11 included studies, 4 were prospective cohort studies (6,16,18,19) and the remaining 7 were retrospective cohort studies (15,17,(20)(21)(22)(23)(24). The studies were implemented in the Netherlands (19), America (15), Singapore (16), Canada (17), China (18), Korea (20,22), Australia (21), Italy (6), Japan (24) and England (23). The average age ranged from 78 to 86.5 years old (More details in Table 1).…”

Section: Characteristics and Quality Of The Included Studiesmentioning

confidence: 99%

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The Impact of Frailty on Adverse Outcomes in Geriatric Hip Fracture Patients: A Systematic Review and Meta-Analysis

Song

Huo

et al. 2022

Front. Public Health

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ObjectiveWith an aging population and advances in medicine, more research focuses on health and longevity in geriatric adults. Recently, frailty has gradually emerged to assess physical conditions. Frailty can be generally described as a multi-dimensional situation of increased vulnerabilities to both endogenous and exogenous stressors. The objective of the review was to evaluate the predictive value of frailty on adverse outcomes in geriatric hip fracture patients.Materials and MethodsWe searched PubMed, Embase, Web of Science, and the Cochrane library for relevant literature about the connection between frailty and poor outcomes in hip fracture elders.ResultsEleven studies involving a total of 45,979 participants were selected in our study. Our results indicated that frailty could significantly predict postoperative and in-patient complications (OR, 1.46; 95% CI, 1.13–1.90; I2 = 77.4%). Frail elders had higher risk of inpatient mortality (OR, 1.68; 95% CI, 1.26–2.25; I2 = 0.0%), 6-month mortality (OR, 1.46; 95% CI, 1.25–1.72; I2 = 0.0%) and ≥1-year mortality (OR, 2.24; 95% CI, 1.66–3.04; I2 = 91.3%). Furthermore, the risk of prolonged hospital stays was 1.15 times more likely in frail patients (95% CI, 1.03–1.28; I2 = 14.8%).ConclusionFrailty can predict adverse outcomes effectively in geriatric hip fracture patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails.

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Section: Discussionmentioning

confidence: 99%

Section: Characteristics and Quality Of The Included Studiesmentioning

confidence: 99%

Section: Characteristics and Quality Of The Included Studiesmentioning

confidence: 99%

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The Impact of Frailty on Adverse Outcomes in Geriatric Hip Fracture Patients: A Systematic Review and Meta-Analysis

Song

Huo

et al. 2022

Front. Public Health

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“…On the other hand, frailty seems to represent a crucial aspect that need to be considered when approaching a diabetic patient with hip fracture. On this regard, the Clinical Frailty Scale is a widely used and easy-to-apply tool for identifying frail geriatric patients, and has a high predictive value of negative outcomes and mortality in hip fractured patients ( 35 , 36 ).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Glycated Hemoglobin in Frail Older Diabetic Patients With Hip Fracture

et al. 2021

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BackgroundPrevious studies have shown increased risk of fracture in older patients with poor or strict glycemic control (glycated hemoglobin, HbA1c, ≥ 8% or < 6-7% respectively); however, these reports did not investigate the oldest-old population. Comprehensive geriatric assessment (CGA) and a patient-centered approach have been proven to improve the quality of care in the management of Type 2 Diabetes Mellitus (T2DM) in the older patients, but data regarding T2DM in patients with fragility fractures are still lacking.AimTo investigate the prognostic role of HbA1c and frailty level in older diabetic patients admitted for hip fracture.MethodsProspective observational cohort study conducted on diabetic geriatric patients consecutively hospitalized for hip fracture in the orthogeriatric unit of a tertiary care hospital. Preoperative comprehensive geriatric assessment (CGA) was performed. Using the Clinical Frailty Scale (CFS), diabetic patients were categorized in robust (CFS < 5) and frail (CFS ≥ 5), and further stratified according to HbA1c values [Tertile 1 (T1) HbA1c < 48 mmol/mol, Tertile 2 (T2) 48-58 mmol/mol and Tertile 3 (T3) > 58 mmol/mol). Comparisons between continuous variables were performed with analysis of non-parametric test for independent samples, while relationships between categorical variables were assessed by chi-square test. Using logistic multivariate regression, we evaluated the determinants of 1-year all-cause mortality in diabetic older patients with hip fracture.ResultsAmong the 1319 older patients (mean age 82.8 ± 7.5 years, 75.9% females) hospitalized for hip fracture, 204 (15.5%) had a previous diagnosis of T2DM. T2DM patients showed an increased proportion of multiple concurrent fractures occurred during the accidental fall or syncope (12.7% vs 11.2%, p=0.02). One-year mortality after hip fracture surgery was significantly higher in T2DM as compared to not diabetic patients (21.2% vs 12.5%, p<0.001). No significant difference in mortality was found across HbA1c tertiles; however, frail diabetic patients in the second and third HbA1c tertiles showed higher mortality risk compared to the robust counterparts (26.9% vs 5%, p=0.001 for T2 and 43.5% vs 13.3%, p=<0.05 for T3), while no difference was observed among those in T1.ConclusionsFrail patients with HbA1c ≥ 48 mmol/L showed an increased mortality risk as compared to robust counterparts. CFS represents an important tool to select diabetic subjects with higher likelihood of adverse outcome.

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Section: Discussionmentioning

confidence: 99%

Table_1.docx

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Performance of the Nottingham Hip Fracture Score and Clinical Frailty Scale as predictors of short and long-term outcomes: a dual-centre 3-year observational study of hip fracture patients

Cited by 20 publications

References 15 publications

The Impact of Frailty on Adverse Outcomes in Geriatric Hip Fracture Patients: A Systematic Review and Meta-Analysis

The Impact of Frailty on Adverse Outcomes in Geriatric Hip Fracture Patients: A Systematic Review and Meta-Analysis

Prognostic Value of Glycated Hemoglobin in Frail Older Diabetic Patients With Hip Fracture

Table_1.docx

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