Validation of the Nottingham Hip Fracture Score (NHFS) in Patients with Hip Fracture: A Prospective Cohort Study in the Netherlands

Rijckevorsel, Veronique A J I M van; Roukema, Gert R.; Klem, T.M.A.L.; Kuijper, M.; Jong, Louis de

doi:10.2147/cia.s321287

Cited by 8 publications

(15 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7,9 The NHFS was proposed for predicting the prognosis after hip fractures in the elderly, which includes age, gender, hemoglobin level at admission, mini-mental state examination, preoperative living status, malignant tumors within 20 years, and complications. [2][3][4] This scoring system can reflect the preoperative physical condition of patients, and all variables can be obtained from their medical history at admission and routine examination. It is characterized by small subjectivity, fewer items, convenient collection, and simple calculation.…”

Section: Prognosis Models For Patients With Hip Fracturesmentioning

confidence: 99%

“…The mortality of these patients during hospitalization is 3%-7%, and the mortality within 30 days after the occurrence of hip fractures is 3%-10%. 3,4 Performing a proper prediction of patients' surgical risk before surgery and accurate risk stratification and prognosis estimation may yield profound clinical significance for improving informed consent and medical safety. 3 Several mortality-prediction tools have been developed to help identify patients at a high risk of mortality.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Performing a proper prediction of patients' surgical risk before surgery and accurate risk stratification and prognosis estimation may yield profound clinical significance for improving informed consent and medical safety. 3 Several mortality-prediction tools have been developed to help identify patients at a high risk of mortality. Among these are the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity, the Charlson Comorbidity Index, and the Nottingham Hip Fracture Score (NHFS).…”

Section: Introductionmentioning

confidence: 99%

“…It is based purely on objective parameters, including age, sex, malignancy, dementia, preoperative living status, hemoglobin levels, and predefined comorbidities. 3 The predefined comorbidities include cerebrovascular, cardiovascular, renal, and respiratory diseases. All factors included in the score are typically registered as part of admission documentation.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Validation of the Nottingham Hip Fracture Score in Predicting Postoperative Outcomes Following Hip Fracture Surgery

Sun

Liu

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective: Although several prognostic models have been developed for patients who underwent hip fracture surgery, their preoperative performance was insufficiently validated. We aimed to verify the effectiveness of the Nottingham Hip Fracture Score (NHFS) for predicting postoperative outcomes following hip fracture surgery. Methods:This was a single-center and retrospective analysis. A total of 702 elderly patients with hip fractures (age ≥ 65 years old) who received treatment in our hospital from June 2020 to August 2021 were selected as the research participants. They were divided into the survival group and the death group based on their survival 30 days after surgery. The multivariate logistic regression model was used to identify the independent risk factors for the 30-day mortality after surgery. The NHFS and American Society of Anaesthesiologists (ASA) grades were used to construct these models, and a receiver operating characteristic curve was plotted to assess their diagnostic significance. A correlation analysis was performed between NHFS and length of hospitalization and mobility 3 months after surgery.Results: There were significant differences in the age, albumin level, NHFS, and ASA grade between both groups (p < 0.05). The length of hospitalization in the death group was longer than the survival group (p < 0.05). The perioperative blood transfusion and postoperative ICU transfer rates in the death group were higher than in the survival group (p < 0.05). The death group's incidence of pulmonary infections, urinary tract infections, cardiovascular events, pressure ulcers, stress ulcers with bleeding, and intestinal obstruction was higher than the survival group (p < 0.05). The NHFS and ASA III were independent risk factors for the 30-day mortality after surgery, regardless of age and albumin level (p < 0.05). The area under the curve (AUC) of the NHFS and ASA grade for predicting the 30-day mortality after surgery was 0.791 (95% confidence interval [CI] 0.709-0.873, p < 0.05) and 0.621 (95% CI 0.477-0.764, p > 0.05), respectively. The NHFS positively correlated with hospitalization length and mobility grade 3 months after surgery (p < 0.05). Conclusion:The NHFS demonstrated a better predictive performance than the ASA score for the 30-day mortality after surgery and positively correlated with the hospitalization length and postoperative activity limitation in elderly patients with hip fractures.

show abstract

Section: Prognosis Models For Patients With Hip Fracturesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Validation of the Nottingham Hip Fracture Score in Predicting Postoperative Outcomes Following Hip Fracture Surgery

Sun

Liu

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…Current literature suggests that NHFS is the best clinical tool to predict 30-day mortality among patients with hip fractures [24]. Designed in one surgical center, NHFS was validated in multicenter studies [25].…”

Section: Clinical Toolsmentioning

confidence: 99%

Femoral and Lateral Femoral Cutaneous Nerve Block as Anesthesia for High-Risk Intertrochanteric Fracture Repair Patients

Klimkiewicz

Gutowski

et al. 2022

JCM

View full text Add to dashboard Cite

Introduction. Intertrochanteric fracture (IF) is a common injury among the elderly. Due to significant comorbidities, anesthesia for IF repair may be challenging. The authors propose femoral nerve block together with a lateral femoral cutaneous nerve block and sedation as an anesthetic technique for most severe cases of IF with contraindications to spinal anesthesia. Methods. In total, 61 patients were enrolled prospectively in a study, 19 received general anesthesia (GA group), 22 spinal anesthesia (SA group), and 20 nerve blocks with sedation (PNB group). Results. Groups were comparable in terms of age, gender, independence, and several comorbidities: diabetes, obesity, underweight, cardiovascular, and cerebrovascular incidents in the past, dementia, chronic obstructive pulmonary disease, and frailty. Heart failure (p = 0.033), hemoglobin < 10 g/dL (p = 0.001) and eGFR < 30 mL/min (p = 0.039) were more frequent in PNB group. PNB group had higher American Society of Anesthesiologists (ASA) (p < 0.001), Nottingham Hip Fracture Score (NHFS) (p < 0.001), and Charlson Comorbidity Index (CCI) (p = 0.002) scales scores, and lower probability of 10-year survival according to CCI (p = 0.012). GA group had more frequent active malignancy (p = 0.041). GA and PNB groups had a higher frequency of hemostasis disorder (p < 0.001). Surgery was completed under the scheduled anesthesia technique. Survival, frequency of cardio and cerebrovascular incidents after surgery, loss of independence, and postoperative delirium were comparable between groups, as well as the length of postoperative stay. Conclusions. Surgical repair of intertrochanteric fracture with intramedullary nailing system among elderly, frail, and sick patients can be conducted under peripheral nerve block. FNB and LFCNB in the combination is a viable option for IT fracture repair.

show abstract

Use of the Shizuoka Hip Fracture Prognostic Score (SHiPS) to Predict Long‐Term Mortality in Patients With Hip Fracture in Japan: A Cohort Study Using the Shizuoka Kokuho Database

Ohata¹,

Nakatani²,

Kaneda

et al. 2023

JBMR Plus

View full text Add to dashboard Cite

Hip fractures are common in patients of advanced age and are associated with excess mortality. Rapid and accurate prediction of the prognosis using information that can be easily obtained before surgery would be advantageous to clinical management. We performed a population-based retrospective cohort study using an 8.5-year Japanese claims database (April 2012-September 2020) to develop and validate a predictive model for long-term mortality after hip fracture. The study included 43,529 patients (34,499 [79.3%] women) aged ≥65 years with first-onset hip fracture. During the observation period, 43% of the patients died. Cox regression analysis identified the following prognostic predictors: sex, age, fracture site, nursing care certification, and several comorbidities (any malignancy, renal disease, congestive heart failure, chronic pulmonary disease, liver disease, metastatic solid tumor, and deficiency anemia). We then developed a scoring system called the Shizuoka Hip Fracture Prognostic Score (SHiPS); this system was established by scoring based on each hazard ratio and classifying the degree of mortality risk into four categories based on decision tree analysis. The area under the receiver operating characteristic (ROC) curve (AUC) (95% confidence interval [CI]) of 1-year, 3-year, and 5-year mortality based on the SHiPS was 0.718 (95% CI, 0.706-0.729), 0.736 (95% CI, 0.728-0.745), and 0.758 (95% CI, 0.747-0.769), respectively, indicating good predictive performance of the SHiPS for as long as 5 years after fracture onset. Even when the SHiPS was individually applied to patients with or without surgery after fracture, the prediction performance by the AUC was >0.7. These results indicate that the SHiPS can predict long-term mortality using preoperative information regardless of whether surgery is performed after hip fracture.

show abstract

Validation of the Nottingham Hip Fracture Score (NHFS) in Patients with Hip Fracture: A Prospective Cohort Study in the Netherlands

Cited by 8 publications

References 28 publications

Validation of the Nottingham Hip Fracture Score in Predicting Postoperative Outcomes Following Hip Fracture Surgery

Validation of the Nottingham Hip Fracture Score in Predicting Postoperative Outcomes Following Hip Fracture Surgery

Femoral and Lateral Femoral Cutaneous Nerve Block as Anesthesia for High-Risk Intertrochanteric Fracture Repair Patients

Use of the Shizuoka Hip Fracture Prognostic Score (SHiPS) to Predict Long‐Term Mortality in Patients With Hip Fracture in Japan: A Cohort Study Using the Shizuoka Kokuho Database

Contact Info

Product

Resources

About