Vochteloo et al developed a score for predicting where a patient will be discharged following repair of a hip fracture. This can identify a patient who may benefit from more aggressive management. The authors are from Leiden University Medical Centre, Reinier de Graaf Group Delft, and Erasmus MC University Medical Centre Rotterdam in The Netherlands.
Patient: adult >= 50 years of age with hip fracture
Parameters:
(1) age of the patient in years
(2) gender
(3) dementia
(4) partner
(5) pre-fracture level of mobility
Parameter
Finding
Points
age in years
< 65 years
0
65 to 79.9 years
10
>= 80 years
20
gender
male
0
female
10
dementia
absent
0
present
20
partner
present
0
absent
10
mobility
inside and outside without aid
0
inside and outside with one or two aids
10
only mobile indoors
40
immobile
40
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 100
• A score >= 30 is associated with discharge to an alternative site (other than home).
Performance:
• The sensitivity was 84% and specificity 65%.
• The positive predictive value was 79%.
• The area under the ROC curve was 0.84.
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