Sernbo score predicts survival after intracapsular hip fracture in the elderly

Dawe, E.J.C.; Lindisfarne, E.A.O.; Singh, T; McFadyen, I.; Stott, P

doi:10.1308/003588413x13511609954653

Cited by 30 publications

(17 citation statements)

References 18 publications

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“…(2013), who found the Sernbo score to be the only predictor of mortality (AUC =0.71, 95% CI: 0.65–0.76) with a sensitivity of 92% and a specificity of 51%. However, Dawe et al.…”

Section: Discussionmentioning

confidence: 99%

The Sernbo score predicts 1-year mortality after displaced femoral neck fractures treated with a hip arthroplasty

et al. 2017

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Background and purposeDisplaced femoral neck fractures (FNFs) are associated with high rates of mortality during the first postoperative year. The Sernbo score (based on age, habitat, mobility, and mental state) can be used to stratify patients into groups with different 1-year mortality. We assessed this predictive ability in patients with a displaced FNF treated with a hemiarthroplasty or a total hip arthroplasty.Patients and methods292 patients (median age 83 (65–99) years, 68% female) with a displaced FNF were included in this prospective cohort study. To predict 1-year mortality, we used a multivariate logistic regression analysis including comorbidities and perioperative management. A receiver operating characteristic (ROC) analysis was used to evaluate the predictive ability of the Sernbo score, which was subsequently divided in a new manner into a low, intermediate, or high risk of death during the first year.ResultsAt 1-year follow-up, the overall mortality rate was 24%, and in Sernbo’s low-, intermediate-, and high-risk groups it was 5%, 22%, and 51%, respectively. The Sernbo score was the only statistically significant predictor of 1-year mortality: odds ratio for the intermediate-risk group was 4.2 (95% Cl: 1.5–12) and for the high-risk group it was 15 (95% CI: 5–40). The ROC analysis showed a fair predictive ability of the Sernbo score, with an area under the curve (AUC) of 0.79 (95% CI: 0.73–0.83). Using a cutoff of less than 11 points on the score gave a sensitivity of 61% and a specificity of 83%.InterpretationThe Sernbo score identifies patients who are at high risk of dying in the first postoperative year. This scoring system could be used to better tailor perioperative care and treatment in patients with displaced FNF.

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“…(2013), who found the Sernbo score to be the only predictor of mortality (AUC =0.71, 95% CI: 0.65–0.76) with a sensitivity of 92% and a specificity of 51%. However, Dawe et al.…”

Section: Discussionmentioning

confidence: 99%

The Sernbo score predicts 1-year mortality after displaced femoral neck fractures treated with a hip arthroplasty

et al. 2017

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“…Such tools have been developed but none has been validated independently, and none is commonly used in clinical practice. 1,[7][8][9][10][11] One such tool is the Nottingham Hip Fracture Score (NHFS), 12 the use of which has been recommended by the Association of Anaesthetists of Great Britain and Ireland. 13 The score is calculated on the basis of age, gender, comorbidities, place of residence (i.e., home or institutional care), the abbreviated mental test score (AMTS) and the level of haemoglobin on admission.…”

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confidence: 99%

Independent validation of the Nottingham Hip Fracture Score and identification of regional variation in patient risk within England

Rushton

Reed

Pratt

2015

The Bone & Joint Journal

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The Nottingham Hip Fracture Score (NHFS) was developed to assess the risk of death following a fracture of the hip, based on pre-operative patient characteristics. We performed an independent validation of the NHFS, assessed the degree of geographical variation that exists between different units within the United Kingdom and attempted to define a NHFS level that is associated with high risk of mortality. The NHFS was calculated retrospectively for consecutive patients presenting with a fracture of the hip to two hospitals in England. The observed 30-day mortality for each NHFS cohort was compared with that predicted by the NHFS using the Hosmer-Lemeshow test. The distribution of NHFS in the observed group was compared with data from other hospitals in the United Kingdom. The proportion of patients identified as high risk and the mortality within the high risk group were assessed for groups defined using different thresholds for the NHFS. In all 1079 hip fractures were included in the analysis, with a mean age of 83 years (60 to 105), 284 (26%) male. Overall 30-day mortality was 7.3%. The NHFS was a significant predictor of 30-day mortality. Statistically significant differences in the distribution of the NHFS were present between different units in England (p < 0.001). A NHFS ≥ 6 appears to be an appropriate cut-point to identify patients at high risk of mortality following a fracture of the hip.

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“…The Nottingham Hip Fracture Score (NHFS), the Sernbo Score, and the POSSUM system consider mortality (e.g., after 30 d or 12 mo) to be the outcome of interest. [ 9 , 12 , 25 ] In our opinion, an adequate treatment result is achieved if patients not only survive the first year after hip fracture but also maintain their independence. Thus, in contrast to previous studies, we defined a composite endpoint that consists of survival without being admitted to a nursing home.…”

Section: Discussionmentioning

confidence: 99%

“…Dawe et al also found only ASA 4 and 5 to be independent outcome factors. [ 25 ] Therefore, the predictive power of the ASA score is likely low when patients with mild systematic diseases (ASA 2) are compared with patients with severe systematic diseases (ASA 3). The ASA score itself is not part of the NHFS or POSSUM system.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] According to these findings and our own results, cognitive ability has been a part of previous scoring systems for hip fracture patients. [ 9 , 25 ] Interestingly, it plays only an inferior role in the NHFS [ 9 ] and is not included in the POSSUM system. [ 12 ] In summary, given the importance of cognitive ability, assessing cognitive ability must become part of the clinical routine.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of noninstitutionalized survival 1 year after hip fracture

Buecking

Eschbach

Knobe³

et al. 2017

Medicine

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Hip fractures are frequent fractures in geriatric patients. These fractures have great socioeconomic implications because of the significantly higher risk of mortality and institutionalization. The aim of this study was to develop a prognostic tool to predict survival without institutionalization within 1 year after hip fracture.A total of 402 hip fracture patients aged >60 years (84% community-dwelling) were included in a prospective observational cohort study. Multiple regression analyses determined independent predictors for noninstitutionalized 1-year survival. Finally, the Marburg Rehabilitation Tool for Hip fractures (MaRTHi) was developed based on these independent predictors.Of the 312 patients who were followed up for 1 year, 168 (54%) survived noninstitutionalized, 104 (33%) died, and 40 (13%) lived in nursing homes. Independent predictors for patients’ noninstitutionalized survival included the American Society of Anesthesiologists (ASA) score [ASA 1 or 2: odds ratio (OR) = 7.828; 95% confidence interval (CI) = 2.496–24.555 and ASA 3: OR = 8.098; 95% CI = 2.982–21.993 compared with ASA 4 or 5], the Mini Mental State Examination upon admission to the hospital (OR = 7.365; 95% CI = 2.967–18.282 for 27–30 compared with 0–10), patients’ age (OR = 2.814; 95% CI = 1.386–5.712 for 75–89 y and OR = 2.520; 95% CI = 0.984–6.453 for 90–99 y compared with 60–74 ys), and prefracture EQ-5D (OR = 2.163; 95% CI = 1.119–4.179 for EQ-5D >0.80 compared with <0.60). The area under the receiver-operating characteristic curve was 0.756 (95% CI = 0.703–0.809), and the sensitivity analysis yielded a MaRTHi score that ranged from 0 to 12 points.The MaRTHi score is the first instrument to predict noninstitutionalized survival with only 4 variables. In addition to 3 well-known factors influencing outcome (age, comorbidities, and cognitive ability), prefracture health-related quality of life was identified as an independent predictor of noninstitutionalized survival. Further studies must be conducted to validate the MaRTHi score and define cutoff scores. Health-related quality of life seems to be an important patient-reported outcome measurement and may play a role in determining patient prognosis.

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Sernbo score predicts survival after intracapsular hip fracture in the elderly

Cited by 30 publications

References 18 publications

The Sernbo score predicts 1-year mortality after displaced femoral neck fractures treated with a hip arthroplasty

The Sernbo score predicts 1-year mortality after displaced femoral neck fractures treated with a hip arthroplasty

Independent validation of the Nottingham Hip Fracture Score and identification of regional variation in patient risk within England

Predictors of noninstitutionalized survival 1 year after hip fracture

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