Sernbo score predicts survival after intracapsular hip fracture in the elderly

Abstract

Introduction: The Sernbo score uses four factors (age, social situation, mobility and mental state) to divide patients into a high-risk and a low-risk group. This study sought to assess the use of the Sernbo score in predicting mortality after an intracapsular hip fracture.

Methods: A total of 259 patients with displaced intracapsular hip fractures were included in the study. Data from prospectively generated databases provided 22 descriptive variables for each patient. These included operative management, blood tests and co-mobidities. Multivariate analysis was used to identify significant predictors of mortality.

Results: The mean patient age was 85 years and the mean follow-up duration was 1.5 years. The one-year survival rate was 92% (± 0.03) in the low-risk group and 65% (± 0.046) in the high-risk group. Four variables predicted mortality: Sernbo score >15 (p=0.0023), blood creatinine (p=0.0026), ASA (American Society of Anaesthesiologists) grade >3 (p=0.0038) and non-operative treatment (p=0.0377). Receiver operating characteristic curve analysis showed the Sernbo score as the only predictor of 30-day mortality (area under curve 0.71 [0.65-0.76]). The score had a sensitivity of 92% and a specificity of 51% for prediction of death at 30 days.

Conclusions: The Sernbo score identifies patients at high risk of death in the 30 days following injury. This very simple score could be used to direct extra early multidisciplinary input to high-risk patients on admission with an intracapsular hip fracture.

Figure 1

Kaplan–Meier estimate of overall survival

Figure 2

Receiver operating characteristic curves showing the ability of different factors to predict 30-day mortality after hip fracture