Sernbo et al reported a score for evaluating an older adult with a hip fracture. It can help to determine which arthroplasty may be better for a patient and to predict postoperative mortality. The authors are from Malmo University Hospital in Sweden.
Patient selection: age >= 70 with hip fracture
Parameters prior to the fracture:
(1) age in years
(2) social situation
(3) mobility
(4) mental status
|
Parameter |
Finding |
Points |
|
age in years |
70 to 79 years of age |
5 |
|
|
>= 80 years of age |
2 |
|
social situation |
independent (does not require caregivers) |
5 |
|
|
dependent and requires nursing or residential care |
2 |
|
mobility |
walks unaided or with one cane |
5 |
|
|
walks with 2 sticks or frams |
2 |
|
|
needs wheelchaire or bed-bound |
2 |
|
mental status |
normal |
5 |
|
|
history of dementia |
2 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 8
• maximum score: 20
• The higher the score the better the survival.
• The scores are not continuous. A score of 14 would be seen with 2 risk factors and a score of 17 with 3. So the score could be replaced by a risk factor count of 0 to 2 versus 3 or 4.
|
Score |
Arthroplasty |
Mortality |
|
8 to 14 |
hemiarthroplasty |
high |
|
15 to 20 |
total arthroplasty |
low |
|
Score |
30-Day Mortality |
1-Year Mortality |
|
8 to 14 |
11% |
8% |
|
15 to 20 |
1% |
35% |
Performance:
• Dawe et al found that the score had a 92% sensitivity and 51% specificity for predicting death at 30 days.
Specialty: Surgery, orthopedic
