Serrano-Lugo Mayra Arely, Luján-Hernández Iván, Ledesma-González Ma Elena, Torres-Salazar Quitzia Libertad
Instituto Mexicano del Seguro Social, Hospital General de Zona con Medicina Familiar No. 16, Mexico.
Universidad Juárez del Estado e Durango, Facultad de Medicina y Nutrición, Mexico.
Rev Esp Geriatr Gerontol. 2025 May-Jun;60(3):101610. doi: 10.1016/j.regg.2024.101610. Epub 2024 Dec 24.
Hip fractures in the elderly pose a significant clinical challenge, with high short-term mortality rates. The Nottingham Hip Fracture Score (NHFS) has proven useful in predicting 30-day mortality in European and Asian populations, but its validity in the Mexican population has not been widely assessed.
To validate the NHFS in predicting 30-day mortality following hip fracture in a Mexican population.
An observational, longitudinal, and prospective study was conducted with 143 patients over 60 years of age with hip fractures treated surgically at Hospital General de Zona No. 16 of IMSS. NHFS was applied upon admission, and health status was verified 30 days post-surgery. The area under the ROC curve (AUC), sensitivity, specificity, and model calibration were calculated.
The 30-day mortality rate was 14.7%. The NHFS had an AUC of 0.72, indicating moderate predictive capacity. A cutoff score of 3.5 yielded 85.7% sensitivity and 24% specificity. A higher cutoff of 4.5 improved specificity (45%) but reduced sensitivity (81%).
The NHFS is a useful tool for predicting 30-day mortality in the Mexican population with hip fractures, though its discriminative ability is moderate. A 3.5 cutoff is recommended when prioritizing sensitivity in clinical settings.
老年髋部骨折带来了重大的临床挑战，短期死亡率很高。诺丁汉髋部骨折评分（NHFS）已被证明在预测欧洲和亚洲人群的30天死亡率方面有用，但尚未在墨西哥人群中广泛评估其有效性。
验证NHFS在预测墨西哥人群髋部骨折后30天死亡率方面的有效性。
对143例60岁以上在IMSS第16区综合医院接受手术治疗的髋部骨折患者进行了一项观察性、纵向和前瞻性研究。入院时应用NHFS，并在术后30天核实健康状况。计算ROC曲线下面积（AUC）、敏感性、特异性和模型校准。
30天死亡率为14.7%。NHFS的AUC为0.72，表明预测能力中等。截断分数为3.5时，敏感性为85.7%，特异性为24%。较高的截断分数4.5提高了特异性（45%），但降低了敏感性（8l%）。
NHFS是预测墨西哥髋部骨折人群30天死亡率的有用工具，但其判别能力中等。在临床环境中优先考虑敏感性时，建议截断分数为3.5。
