Parameters:
(1) gender
(2) age
(3) cardiopulmonary comorbid conditions as measured by the ASA classification
(4) fracture location
(5) implant
|
Parameter
|
Findings
|
Points
|
|
gender
|
male
|
0
|
|
|
female
|
1
|
|
age in years
|
<= 70 years of age
|
0
|
|
|
> 70 years of age
|
1
|
|
comorbid conditions
|
ASA 1 or 2
|
0
|
|
|
ASA 3 or 4
|
1
|
|
fracture location
|
intracapsular
|
0
|
|
|
intertrochanteric
|
1
|
|
implant
|
not cemented
|
0
|
|
|
cemented
|
1
|
where:
• Intracapsular fractures include subcapital, transcervical and basicervical fractures.
• Cemented prosthesis may be associated with transient hypotensive episodes.
• Cardiopulmonary disease includes hypertension, COPD, cardiac arrhythmias, congestive heart failure, and ischemic heart disease.
• ASA class 5 (moribund) was not included.
total number of risk factors =
= SUM(points for all 5 findings)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 5
• A patient with one or more of these risk factors should be monitored more closely.
The authors found that the mortality rate after arthroplasty for acute hip fracture was almost 10 times that for elective procedures.
