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 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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Publication Details

Journal
Scientific Reports
Published
2025-02-15
DOI
https://doi.org/10.1038/s41598-025-89869-2
Citations
2
Primary Topic
Hip and Femur Fractures
Type
article
Field-Weighted Citation Impact
4.01

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article

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

Raquel Simões Ballarin, Filipe Welson Leal Pereira, Laís Helena Navarro e Lima, Sérgio Alberto Rupp de Paiva et al.
2 citations
Scientific Reports
Hip and Femur Fractures
4.01
article

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

Raquel Simões Ballarin, Filipe Welson Leal Pereira, Laís Helena Navarro e Lima, Sérgio Alberto Rupp de Paiva, Flávio Cruz Ferro, José Pedro Ferreira, Opinder Sahota, V. Mayoral, Paulo do Nascimento, Adam Gordon, Taline Lazzarin, Paula S. Azevedo, Marcos Ferreira Minicucci, Marcos Adriano Garcia Campos, Lucas Vaz Peres, David Nicoletti Gumieiro, Emílio Martins Curcelli, Marina Politi Okoshi, Vitor Soares, Víctor Bernardi, D.T.B. Pereira, Thais Caroline Silva Picolli, Theodor Terra Mayer Tibeau
article en
2 citations

Abstract

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.

Scientific ReportsVol. 15(1)
Nottingham University Hospitals NHS Trust (GB), Queen Mary University of London (GB), Duke University (US), Barts Health NHS Trust (GB), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR), University of Manitoba (CA), Universidade Estadual Paulista (Unesp) (BR)
Fundação de Amparo à Pesquisa do Estado de São Paulo, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Universidade Estadual Paulista
Good health and well-being
Openalex Percentile: Top 9%
Hip and Femur Fractures
4.01
DOIOpen Access PDFOpenAlex
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