Jiang et al developed a score for predicting mortality for a patient in the hospital with a hip fracture. This can help to identify a patient who may benefit from more aggressive management. The authors are from Royal Alexandra Hospital, University of Alberta, and Glenrose Rehabilitation Hospital in Edmondton.
Patient: hip fracture, age >= 60 years
Parameters:
(1) age in years
(2) gender
(3) residence prior to admission
(4) COPD
(5) pneumonia
(6) ischemic heart disease
(7) history of myocardial infarction
(8) cardiac arrhythmia
(9) congestive heart failure (CHF)
(10) malignancy
(11) malnutrition
(12) electrolyte disorder
(13) renal failure
|
Parameter |
Finding |
Points |
|---|---|---|
|
age in years |
60 to 69 years |
0 |
|
|
70 to 79 years |
6 |
|
|
80 to 89 years |
7 |
|
|
90 or more years |
13 |
|
gender |
female |
0 |
|
|
male |
6 |
|
residence prior to admission |
long-term care facility |
4 |
|
|
other |
0 |
|
COPD |
absent |
0 |
|
|
present |
4 |
|
pneumonia |
absent |
0 |
|
|
present |
14 |
|
ischemic heart diseaes |
absent |
0 |
|
|
present |
5 |
|
history of myocardial infarction |
absent |
0 |
|
|
present |
13 |
|
cardiac arrhythmia |
none |
0 |
|
|
any |
5 |
|
congestive heart failure |
absent |
0 |
|
|
present |
7 |
|
malignancy |
absent |
0 |
|
|
present |
13 |
|
malnutrition |
absent |
0 |
|
|
present |
20 |
|
electrolyte disorder |
none |
0 |
|
|
any |
5 |
|
renal failure |
absent |
0 |
|
|
present |
19 |
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: 0
• maximum score: 128
• The higher the score the greater the risk of in-hospital mortality.
• The greater the score the greater the risk of 1-year mortality.
|
Total Score |
In-Hospital Mortality |
1-Year Mortality |
|
0 to 7 |
0.6% |
12% |
|
8 to 13 |
1.7% |
23% |
|
14 to 21 |
6% |
37% |
|
22 or more |
16% |
52% |
Purpose: To predict the risk of in-hospital mortality for a patient with a hip fracture using the score of Jiang et al.
Specialty: Surgery, orthopedic
Objective: risk factors, severity, prognosis, stage
ICD-10: S72,
