Performance of the Nottingham hip fracture score (NHFS) as a predictor of 30-day mortality after proximal femur fracture in an older people Brazilian cohort

Perioperative risk assessment helps inform clinical practice for older people with hip fractures. This is a cohort study, where perioperative risk screening, including NHFS, was performed at admission, followed by an evaluation of 30-day outcomes. 503 patients were included, 73% female, 79.4 ± 9.3 y...

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Detalles Bibliográficos
Autores: Ferro, Flávio Cruz [UNESP], Campos, Marcos Adriano Garcia, Picolli, Thais Caroline Silva [UNESP], de Sá Mayoral, Vania [UNESP], Soares, Victoria Moralez [UNESP], Ferreira, Jessica Caroline [UNESP], Peres, Lucas Dias Borges [UNESP], Tibeau, Theodor Terra Mayer [UNESP], Bernardi, Victor El Chihimi [UNESP], Pereira, David Nascimento [UNESP], Gumieiro, David Nicoletti [UNESP], Curcelli, Emilio Carlos [UNESP], Navarro e Lima, Lais Helena [UNESP], do Nascimento Junior, Paulo [UNESP], Lazzarin, Taline [UNESP], Ballarin, Raquel Simões [UNESP], Okoshi, Marina Politi [UNESP], Minicucci, Marcos Ferreira [UNESP], de Paiva, Sergio Alberto Rupp [UNESP], Gordon, Adam Lee, Sahota, Opinder, Pereira, Filipe Welson Leal [UNESP], Azevedo, Paula Schmidt [UNESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:Brasil
Institución:Universidade Estadual Paulista (UNESP)
Repositorio:Repositório Institucional da UNESP
Idioma:inglés
OAI Identifier:oai:repositorio.unesp.br:11449/297441
Acceso en línea:http://dx.doi.org/10.1038/s41598-025-89869-2
https://hdl.handle.net/11449/297441
Access Level:acceso abierto
Palabra clave:Femur fracture
Hip fracture
Mortality
Older people
Risk
Surgery
Descripción
Sumario:Perioperative risk assessment helps inform clinical practice for older people with hip fractures. This is a cohort study, where perioperative risk screening, including NHFS, was performed at admission, followed by an evaluation of 30-day outcomes. 503 patients were included, 73% female, 79.4 ± 9.3 years old; 58% presented extracapsular and 42% intracapsular fractures, with a 30-day mortality of 9%. The NHFS was higher in the patients who died at 5.6 ± 1.1 compared to survivals at 4.3 ± 1.5 (p-value < 0.001). NHFS > 4 was associated with 30-day mortality observed by Cox regression adjusted by fracture type: HR 4.55 (95% CI 2.10–9.82) (p-value < 0.001) and Kaplan-Meyer Curve (HR 3.94; 95% CI 2.19–7.07; p-value < 0.001). ROC curve showed the accuracy of NHFS in explaining 30-day mortality (AUC 0.74; 95% CI 0.67–0.81). Complications were higher among patients with NHFS > 4. The performance of NHFS was better than the traditional perioperative risk ASA score. Therefore, NHFS can be implemented in real-world clinical practice to estimate the 30-day mortality risk for hip fracture in older patients in Brazil. NHFS > 4 is critical for 30-day mortality and complications; this cutoff helps inform clinical practice. The present study might motivate other centers to consider NHFS in their perioperative risk assessment routine.

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