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. 2021 Aug 21:16:1555-1562.
doi: 10.2147/CIA.S321287. eCollection 2021.

Validation of the Nottingham Hip Fracture Score (NHFS) in Patients with Hip Fracture: A Prospective Cohort Study in the Netherlands

Veronique A J I M van Rijckevorsel  1 , Gert R Roukema  1 , Taco M A L Klem  2 , Tjallingius M Kuijper  3 , Louis de Jong  2 ; Dutch Hip Fracture Registry Collaboration
Affiliations

Validation of the Nottingham Hip Fracture Score (NHFS) in Patients with Hip Fracture: A Prospective Cohort Study in the Netherlands

Veronique A J I M van Rijckevorsel et al. Clin Interv Aging. .

Abstract

Introduction: The Nottingham Hip Fracture Score (NHFS) was developed to predict 30-day mortality for patients with hip fracture. This study aimed to validate the NHFS in a cohort with sufficient statistical power.

Methods: Data were extracted from a prospective hip-fracture database (FAMMI). Patients were included between January 1, 2018 and January 11, 2021. All consecutively admitted patients ≥18 years of age with a hip fracture (ie, femoral neck fracture, intertrochanteric fracture, and subtrochanteric fracture) were included. Mann-Whitney's U values were calculated to find potential miscalibration of the NHFS formula. Discrimination evaluation was performed using the concordance statistic as an equivalent to area under the receiver-operating curve.

Results: In total, 2,458 patients were included. Mean age was 80±12 years, and 66% were women (n=1,631). Median NHFS was 5 (4-6) and overall 30-day mortality 7.9% (n=195). Overall goodness of fit was tested with Pearson's ?2 (11.8, df 10; P=0.297). No statistically significant signs of miscalibration were found (Mann-Whitney U, P=0.08). Discrimination was tested with area under the receiver- operating curve, which was 72.1% (95% CI 68.7%-75.4%). However, observed 30-day mortality in our population of hip-fracture patients was slightly higher than the NHFS prediction.

Conclusion: The NHFS seemed to predict 30-day mortality with reasonable accuracy for patients with a hip fracture in a population within the Netherlands.

Keywords: 30-day mortality; NHFS; hip fractures; prediction tool; validation.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of patient inclusion.
Figure 2
Figure 2
MortalityOobserved in Rotterdam cohort compared to modified NHFS.
See this image and copyright information in PMC

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