title: Nottingham Hip Fracture Score as a predictor of one year mortality in patients undergoing surgical repair of fractured neck of femur.
abstract: BACKGROUND
  Surgical repair of hip fractures is associated with high postoperative mortality. The identification of high-risk patients might be of value in aiding clinical management decisions and resource allocation. The Nottingham Hip Fracture Score (NHFS) is a scoring system validated for the prediction of 30 day mortality after hip fracture surgery. It is made up of seven independent predictors of mortality that have been incorporated into a risk score: age (66-85 and ≥86 yr); sex (male); number of co-morbidities (≥2), admission mini-mental test score (≤6 out of 10), admission haemoglobin concentration (≤10 g dl(-1)), living in an institution; and the presence of malignancy. We investigated whether the NHFS was a predictor of 1 yr mortality in patients undergoing surgical repair of fractured neck of femur.
  
  
  METHODS
  NHFS was retrospectively calculated for 6202 patients who had undergone hip fracture surgery between 1999 and 2009. One year and 30 day postoperative mortality data were collected both from hospital statistics and the Office of National Statistics.
  
  
  RESULTS
  Overall mortality was 8.3% at 30 days and 29.3% at 1 yr. An NHFS of ≤4 was considered low risk and a score of ≥5 high risk. Survival was greater in the low-risk group at 30 days [96.5% vs 86.3% (P<0.001)] and at 1 yr [84.1% vs 54.5% (P<0.001)].
  
  
  CONCLUSIONS
  NHFS can be used to stratify the risk of 1 yr mortality after hip fracture surgery.
authors.affiliation: University Division of Anaesthesia and Intensive Care, University of Nottingham, Nottingham, UK. matt.wiles@nottingham.ac.uk
authors.forename: M D
authors.initials: MD
authors.lastname: Wiles
authors.forename: C G
authors.initials: CG
authors.lastname: Moran
authors.forename: O
authors.initials: O
authors.lastname: Sahota
authors.forename: I K
authors.initials: IK
authors.lastname: Moppett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004812:Epidemiologic Methods; D005260:Female; D005265:Femoral Neck Fractures / Q000401:mortality / Q000601:surgery*; D005592:Fracture Fixation / Q000009:adverse effects; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome