Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality
Objectives Frailty is common among patients with hip fracture and may, in part, contribute to the increased risk of mortality and morbidity after hip fracture surgery. This study aimed to develop a novel frailty score for patients with traumatic hip fracture that could be used to predict postoperati...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-10-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/7/1/e000962.full |
| _version_ | 1826956408004804608 |
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| author | Yang Cao Shahin Mohseni Ahmad Mohammad Ismail Tomas Borg Maximilian Peter Forssten Gary Alan Bass Dhanisha Jayesh Trivedi Lovisa Ekestubbe |
| author_facet | Yang Cao Shahin Mohseni Ahmad Mohammad Ismail Tomas Borg Maximilian Peter Forssten Gary Alan Bass Dhanisha Jayesh Trivedi Lovisa Ekestubbe |
| author_sort | Yang Cao |
| collection | DOAJ |
| description | Objectives Frailty is common among patients with hip fracture and may, in part, contribute to the increased risk of mortality and morbidity after hip fracture surgery. This study aimed to develop a novel frailty score for patients with traumatic hip fracture that could be used to predict postoperative mortality as well as facilitate further research into the role of frailty in patients with hip fracture.Methods The Orthopedic Hip Frailty Score (OFS) was developed using a national dataset, retrieved from the Swedish National Quality Registry for Hip Fractures, that contained all adult patients who underwent surgery for a traumatic hip fracture in Sweden between January 1, 2008 and December 31, 2017. Candidate variables were selected from the Nottingham Hip Fracture Score, Sernbo Score, Charlson Comorbidity Index, 5-factor modified Frailty Index, as well as the Revised Cardiac Risk Index and ranked based on their permutation importance, with the top 5 variables being selected for the score. The OFS was then validated on a local dataset that only included patients from Orebro County, Sweden.Results The national dataset consisted of 126,065 patients. 2365 patients were present in the local dataset. The most important variables for predicting 30-day mortality were congestive heart failure, institutionalization, non-independent functional status, an age ≥85, and a history of malignancy. In the local dataset, the OFS achieved an area under the receiver-operating characteristic curve (95% CI) of 0.77 (0.74 to 0.80) and 0.76 (0.74 to 0.78) when predicting 30-day and 90-day postoperative mortality, respectively.Conclusions The OFS is a significant predictor of short-term postoperative mortality in patients with hip fracture that outperforms, or performs on par with, all other investigated indices.Level of evidence Level III, Prognostic and Epidemiological. |
| first_indexed | 2024-04-12T16:19:22Z |
| format | Article |
| id | doaj.art-c266216b514f4510ae3a1e61e8554845 |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2025-02-18T00:07:01Z |
| publishDate | 2022-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-c266216b514f4510ae3a1e61e85548452024-11-30T08:45:13ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762022-10-017110.1136/tsaco-2022-000962Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortalityYang Cao0Shahin Mohseni1Ahmad Mohammad Ismail2Tomas Borg3Maximilian Peter Forssten4Gary Alan Bass5Dhanisha Jayesh Trivedi6Lovisa Ekestubbe7Oncology Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, ChinaSchool of Medical Sciences, Orebro University, Orebro, SwedenSchool of Medical Sciences, Orebro University, Orebro, SwedenDepartment of Orthopedic Surgery, Örebro University Hospital, Örebro, SwedenDepartment of Orthopedic Surgery, Orebro University Hospital, Orebro, SwedenSchool of Medical Sciences, Orebro University, Orebro, SwedenSchool of Medical Sciences, Orebro University, Orebro, SwedenSchool of Medical Sciences, Orebro University, Orebro, SwedenObjectives Frailty is common among patients with hip fracture and may, in part, contribute to the increased risk of mortality and morbidity after hip fracture surgery. This study aimed to develop a novel frailty score for patients with traumatic hip fracture that could be used to predict postoperative mortality as well as facilitate further research into the role of frailty in patients with hip fracture.Methods The Orthopedic Hip Frailty Score (OFS) was developed using a national dataset, retrieved from the Swedish National Quality Registry for Hip Fractures, that contained all adult patients who underwent surgery for a traumatic hip fracture in Sweden between January 1, 2008 and December 31, 2017. Candidate variables were selected from the Nottingham Hip Fracture Score, Sernbo Score, Charlson Comorbidity Index, 5-factor modified Frailty Index, as well as the Revised Cardiac Risk Index and ranked based on their permutation importance, with the top 5 variables being selected for the score. The OFS was then validated on a local dataset that only included patients from Orebro County, Sweden.Results The national dataset consisted of 126,065 patients. 2365 patients were present in the local dataset. The most important variables for predicting 30-day mortality were congestive heart failure, institutionalization, non-independent functional status, an age ≥85, and a history of malignancy. In the local dataset, the OFS achieved an area under the receiver-operating characteristic curve (95% CI) of 0.77 (0.74 to 0.80) and 0.76 (0.74 to 0.78) when predicting 30-day and 90-day postoperative mortality, respectively.Conclusions The OFS is a significant predictor of short-term postoperative mortality in patients with hip fracture that outperforms, or performs on par with, all other investigated indices.Level of evidence Level III, Prognostic and Epidemiological.https://tsaco.bmj.com/content/7/1/e000962.full |
| spellingShingle | Yang Cao Shahin Mohseni Ahmad Mohammad Ismail Tomas Borg Maximilian Peter Forssten Gary Alan Bass Dhanisha Jayesh Trivedi Lovisa Ekestubbe Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality Trauma Surgery & Acute Care Open |
| title | Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality |
| title_full | Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality |
| title_fullStr | Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality |
| title_full_unstemmed | Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality |
| title_short | Developing and validating a scoring system for measuring frailty in patients with hip fracture: a novel model for predicting short-term postoperative mortality |
| title_sort | developing and validating a scoring system for measuring frailty in patients with hip fracture a novel model for predicting short term postoperative mortality |
| url | https://tsaco.bmj.com/content/7/1/e000962.full |
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