Outcome after femoral neck fractures: a comparison of Harris Hip Score, Eq-5d and Barthel Index

Abstract

Introduction: The objective of this study was to evaluate the discriminatory ability and responsiveness of the Harris Hips Score, the Barthel Index and the Eq-5d (Euroqol) in an unselected population of patients with displaced femoral neck fracture.

Methods: Data were collected at 4 and 12 months after surgery from a population of 222 patients. Patients with complete data sets who suffered a serious complication (n=23) were compared with patients with no complication (n=56). The assessment scales' ability to discriminate between the groups was calculated, as was the change score and the standardised response mean.

Results: All scales were able to discriminate between the complications group and the non-complications group at 4 months, but only Harris Hip Score had independent explanatory ability in a logistic regression analysis. All scales showed a positive change score for the complications group from 4 to 12 months. The standardised response mean was 0.75 for Harris Hip Score, 0.40 for Barthel Index, 0.46 for the Eq-5d index score, and 0.57 for the Eq-5d visual analogue scale. Barthel Index had a marked ceiling effect with 51/79 (65%) scoring 19 or 20 at 4 months. The response rate was 71-87% for Eq-5d and 96-98% for Harris Hip Score and Barthel Index.

Conclusion: All the scales may be used for this patient group, but Harris Hip Score performed better than the other scales.