A Comparative Analysis of Age, BMI, Age/BMI Ratio, Nottingham Hip Fracture Score, and American Society of Anesthesiologists (ASA) Grade as Predictors of 30-Day Mortality After Neck of Femur Fractures: A Retrospective Cohort Study.

Background and objective Hip fracture is a condition associated with high mortality rates, necessitating the use of risk assessment tools to optimise patient care. This study aimed to introduce and describe a novel score using Age/BMI as an improved predictor of 30-day mortality Methods A retrospective cohort study was conducted at a high-volume neck of the femur centre. Data from 574 patients treated over one year were collected and analysed. Multivariate logistic regression analysis was used to determine variables that significantly increased the risk of 30-day mortality. Results A total of 574 patients were identified: 388 females and 186 males. The overall mortality of the patient cohort at the time of data collection was 21.78% (n=125). The 30-day mortality was found to be 5.75% (n=33) while the one-year mortality rate was 21.08% (n=121). The key risk factors for mortality in neck of femur fractures, highlighted in the literature review, were compared against the binomial outcome variable of 30-day mortality. Categorical data analysis was first completed to highlight key trends. A regression analysis then demonstrated the significance of each factor. Age (p=0.75207), BMI (p=0.97674), and Age/BMI (p=0.92205) showed no statistical significance. The Nottingham Hip Fracture Score (NHFS) was marginally significant (p=0.05749). The American Society of Anesthesiologists (ASA) grade was shown to be statistically significant, emerging as the strongest predictor of 30-day mortality (p=0.00953). Conclusions Our findings show that current guidelines utilising ASA and NHFS are excellent predictors of 30-day mortality in hip fracture patients. The proposed Age/BMI score did not demonstrate efficacy in this cohort. Further research is warranted to explore alternative predictors and enhance risk assessment in this population.