Are Evaluation Scores Reliable Predictors of 30-Day and 1-Year Mortality in Fragility Neck of Femur Fractures?

Introduction: An aging population is one major concern of healthcare providers, with fragility fractures affecting individuals over the age of 65. While there are multiple tests available for predicting mortality, we have yet to define the best clinical assessment tool for fragility fractures. Material and Methods: All patients admitted in our hospital from 2017 until 2023 with fragility NOF fracture were included in the study. The collected data included demographic data and several scales, included the AMTS score, the new mobility score, the ASA grade, the Charlson Index, the Nottingham Hip Fracture score and the Sernbo score. The 30 day mortality was collected as well. Patients without full data were removed from the study. Results: There were 380 patients forming the study cohort and after exclusions a total of 356 patients aged 81.73± 9.24 years, with fragility neck of femur fractures were finally included in the study. The patients had mean ASA grade of 2.36±0.6, while pre-operatively the NMS score was 5.77±2.6, the Charlson Score 4.17±2.3, the NHFS 5±1.2 and the Sernbo score 15.23±3.8. The 30-day mortality was 9.5% and the 1-year mortality was 28.8%. In the multivariant model with the 30-day mortality as dependent variable, all variables lose their unique significance. In the multivariant model with the 1 year mortality as dependent variable the only variable that retained its significance as independent predictive factor after a fragility neck of femur fracture was the new mobility score (p=0.024). Conclusion: The multivariant analysis of the present study revealed that New Mobility Score is the only independent predictive risk factors for 1 year mortality after a fragility hip fracture. Although the Sernbo and NHFS scores are useful, they do not appear to predict the 30-day and the 1 year mortality of the patients in this cohort.