Outcome after femoral neck fractures: a comparison of Harris Hip Score, Eq-5d and Barthel Index.
BACKGROUND
The objective of this study was to evaluate the discriminatory ability and responsiveness of the Harris Hips Score, the Barthel Index and the Eq-5d (Euroqol) in an unselected population of patients with displaced femoral neck fracture.


METHODS
Data were collected at 4 and 12 months after surgery from a population of 222 patients. Patients with complete data sets who suffered a serious complication (n=23) were compared with patients with no complication (n=56). The assessment scales' ability to discriminate between the groups was calculated, as was the change score and the standardised response mean.


RESULTS
All scales were able to discriminate between the complications group and the non-complications group at 4 months, but only Harris Hip Score had independent explanatory ability in a logistic regression analysis. All scales showed a positive change score for the complications group from 4 to 12 months. The standardised response mean was 0.75 for Harris Hip Score, 0.40 for Barthel Index, 0.46 for the Eq-5d index score, and 0.57 for the Eq-5d visual analogue scale. Barthel Index had a marked ceiling effect with 51/79 (65%) scoring 19 or 20 at 4 months. The response rate was 71-87% for Eq-5d and 96-98% for Harris Hip Score and Barthel Index.


CONCLUSIONS
All the scales may be used for this patient group, but Harris Hip Score performed better than the other scales.
Frihagen
Frede
F
Orthopaedic Centre, Ullevaal University Hospital, Oslo, Norway. j.f.frihagen@medisin.uio.no
Grotle
Margreth
M
Madsen
Jan Erik
JE
Wyller
Torgeir Bruun
TB
Mowinckel
Petter
P
Nordsletten
Lars
L
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000534:rehabilitation; D004812:Epidemiologic Methods; D005260:Female; D005265:Femoral Neck Fractures / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000534:rehabilitation; D006305:Health Status Indicators; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D016896:Treatment Outcome