Department of Orthopaedics, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Department of Medicine, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
Med Sci Monit. 2018 Oct 27;24:7665-7672. doi: 10.12659/MSM.909943.
BACKGROUND The Nottingham Hip Fracture Score (NHFS) is validated as a predictive mortality tool in patients with hip fracture. However, it has not been modified or validated widely other than in the UK NHS health systems. MATERIAL AND METHODS We assessed the predictive capability of the NHFS for 30-day mortality after surgery for hip fracture in the Greek population and then compared the original model to a modified one. We applied the NHFS to the Greek population and created a modified model of the NHFS by including the New Mobility Score (NMS) (Parker and Palmer, 1993) to the evaluated parameters and excluding the parameter of institution. We ran a prospective study over a period of 3 years in our institution, collecting full data from 349 patients. All data were analyzed using SPSS, version 20. RESULTS From all 349 patients, with a mean age of 80.82 years, only 85 (24.4%) were men. All patients were followed up for at least 30 days and the NHFS and modified NHFS prediction were compared with the mortality rate of patients. The area under the ROC curve for both models suggested acceptable accuracy (original NHFS 0.83, modified NHFS 0.84). Calibration was acceptable for both models (Hosmer-Lemeshow p=0.31 and 0.11, respectively). CONCLUSIONS Both the original and the modified NHFS were significant predictors of 30-day mortality. A higher-power study might be able to show superiority of the modified one for the Greek population in the future.
诺丁汉髋部骨折评分（NHFS）已被验证为髋部骨折患者的死亡率预测工具。然而，除了在英国国民保健制度的医疗体系中，它并没有被广泛地修改或验证。
我们评估了 NHFS 在希腊人群中预测髋部骨折手术后 30 天死亡率的能力，然后将原始模型与改良模型进行比较。我们将 NHFS 应用于希腊人群，并通过将新移动评分（NMS）（Parker 和 Palmer，1993）纳入评估参数并排除机构参数，创建了改良的 NHFS 模型。我们在我们的机构进行了为期 3 年的前瞻性研究，从 349 名患者中收集了完整的数据。所有数据均使用 SPSS 版本 20 进行分析。
从我们的 349 名患者中，平均年龄为 80.82 岁，只有 85 名（24.4%）是男性。所有患者均至少随访 30 天，将 NHFS 和改良 NHFS 预测与患者死亡率进行比较。两种模型的 ROC 曲线下面积均提示具有可接受的准确性（原始 NHFS 为 0.83，改良 NHFS 为 0.84）。两种模型的校准均可以接受（Hosmer-Lemeshow p 值分别为 0.31 和 0.11）。
原始和改良的 NHFS 均是 30 天死亡率的重要预测因素。未来更大规模的研究可能能够显示改良的 NHFS 对希腊人群的优越性。
