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.

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 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 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 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.