Almelo Hip Fracture Score (AHFS)

Description

Nijmeijer et al reported the Almelo Hip Fracture Score (AHFS) to evaluate an older adult with a hip fracture. This can help to identify a patient who may require more aggressive management following surgery. The authors are from Ziekenhuisgroep, ZGT Academy, University Medical Centre Groningen and Leyden Academy on Vitality and Aging in The Netherlands.

Patient selection: frail adult >= 70 years of age with hip fracture with ASA <= 4

Outcome: early mortality after surgery (within first 30 days after surgery)

Parameters:

(1) age

(2) gender

(3) admission serum hemoglobin in g/dL

(4) cognitive frailty

(5) living in an institution

(6) number of comorbidities

(7) malignancy

(8) Parker Mobility Score (from 0 to 9)

(9) ASA score

Parameter	Finding	Points
age	70 to 85 years	3
	>= 86 years	4
gender	male	1
	female	0
admission serum hemoglobin	<= 10 g/dL	1
	> 10 g/dL	0
cognitive frailty	no	0
	yes	1
living in an institution	no	0
	yes	1
number of comorbidities	0 or 1	0
	>= 2	1
malignancy	no	0
	yes	1
Parker Mobility Score	<= 5	2
	> 5	0
ASA score	1 or 2	0
	3	3
	4	7

total score =

= SUM(points for all 9 parameters)

Interpretation:

• minimum score: 3

• maximum score: 19

• The higher the score the greater the risk of early mortality

Score	Early Mortality
3 or 4	0%
5	1%
6	1.5%
7	2.1%
8	3.1%
9	4.5%
10	6.5%
11	9.2%
12	12.9%
13	17.9%
14	24.2%
15	31.9%
16	40.7%
17	50.2%
18	59.7%
19	68.4%

Performance:

• The area under the ROC curve is 0.82.

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