Predicting 30-Day and 180-Day Mortality in Elderly Proximal Hip Fracture Patients: Evaluation of 4 Risk Prediction Scores at a Level I Trauma Center
Arastoo Nia,
Domenik Popp,
Georg Thalmann,
Fabian Greiner,
Natasa Jeremic,
Robert Rus,
Stefan Hajdu,
Harald K. Widhalm
Affiliations
Arastoo Nia
Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Domenik Popp
Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Georg Thalmann
Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Fabian Greiner
Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Natasa Jeremic
Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Robert Rus
Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Stefan Hajdu
Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Harald K. Widhalm
Department of Orthopedics and Traumatology, Clinical Division of Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
This study evaluated the use of risk prediction models in estimating short- and mid-term mortality following proximal hip fracture in an elderly Austrian population. Data from 1101 patients who sustained a proximal hip fracture were retrospectively analyzed and applied to four models of interest: Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), Charlson Comorbidity Index, Portsmouth-POSSUM and the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) Risk Score. The performance of these models according to the risk prediction of short- and mid-term mortality was assessed with a receiver operating characteristic curve (ROC). The median age of participants was 83 years, and 69% were women. Six point one percent of patients were deceased by 30 days and 15.2% by 180 days postoperatively. There was no significant difference between the models; the ACS-NSQIP had the largest area under the receiver operating characteristic curve for within 30-day and 180-day mortality. Age, male gender, and hemoglobin (Hb) levels at admission p < 0.001). Among the four scores, the ACS-NSQIP score could be best-suited clinically and showed the highest discriminative performance, although it was not specifically designed for the hip fracture population.