Development of a new comprehensive preoperative risk score for predicting 1-year mortality in patients with hip fracture: the HULP-HF score. Comparison with 3 other risk prediction models
Hip Int. 2020 Aug 7;1120700020947954. doi: 10.1177/1120700020947954
Rocío Menéndez-Colino 1 2, Alicia Gutiérrez Misis 2 3, Teresa Alarcon 1 2 4 3, Jesús Díez-Sebastián 5, Macarena Díaz de Bustamante 2 6, Rocío Queipo 2 4 3, Angel Otero 2 4 3, Juan I González-Montalvo 1 2 4 3
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Falls and Fractures category contains the following
222 items in FALLS and FRACTURES
- see also Overview Seniors and Vitamin D
- Overview Fractures and Falls and Vitamin D
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- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Falls cut in half by 100,000 IU vitamin D monthly - RCT 2016
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
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- Hip fracture recovery best with home exercise plus Vitamin D – RCT Dec 2018
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Purpose: The aim of this study was to develop a new comprehensive preoperative risk score for predicting mortality during the first year after hip fracture (HF) and its comparison with 3 other risk prediction models.
Methods: All patients admitted consecutively with a fragility HF during 1 year in a co-managed orthogeriatric unit at a university hospital were assessed and followed for 1 year. Factors independently associated with 1-year mortality were used to create the HULP-HF (Hospital Universitario La Paz - Hip Fracture) score. The predictive validity, discrimination and calibration of the HULP-HF score, the American Society of Anesthesiologists (ASA) scale, the abbreviated Charlson comorbidity index (a-CCI) and the Nottingham Hip Fracture score (NHFS) were compared. Discriminative performance was assessed using the area under the curve (AUC) and calibration by the Hosmer-Lemeshow goodness-of-fit-test.
Results: 509 patients were included. 1-year mortality was 23.2%.
The 8 independent mortality risk factors included in the HULP-HF score were
- age >85 years,
- baseline functional and cognitive impairment,
- low body mass index,
- heart disease,
- low hand-grip strength,
- anaemia on admission, and
- secondary hyperparathyroidism associated with vitamin D deficiency.
The AUC was 0.79 in the HULP-HF score, 0.66 in the NHFS, 0.61 in the abbreviated CCI and 0.59 in the ASA scale. The HULP-HF score, the NHFS and the abbreviated CCI all presented good levels of calibration (p > 0.05).
Conclusions: The HULP-HF score has a predictive capacity for 1-year mortality in HF patients slightly superior to that of other previously existing scores.Risk factors for death after hip fracture surgery – 7 of the 8 are associated with low vitamin D – Aug 2020
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